scholarly journals Study of functional outcome in low grade spondylolisthesis operated by pedicular screw instrumentation and fusion

2021 ◽  
Vol 9 (1) ◽  
pp. 34-40
Author(s):  
Dr. Lalit C. Panchal ◽  
◽  
Dr. Vijay L Sarukte ◽  
Dr. Ravi N Bhanushali ◽  
◽  
...  
Keyword(s):  
Functional Outcome ◽  
Interbody Fusion ◽  
Posterior Lumbar Interbody Fusion ◽  
Low Grade ◽  
Lumbar Interbody Fusion ◽  
Excellent Outcome ◽  
Satisfactory Outcome ◽  
Pedicular Screw ◽  
Rod System ◽  
Study Population

Background: Functional outcome following instrumental spinal surgery for spondylolisthesis inphysically energetic patients is crucial. The present study was undertaken to evaluate the functionaloutcome of low-grade spondylolisthesis accompanied by low back pain with or without radiculopathy,with standard surgical procedure posterior lumbar interbody fusion with instrumentation. Method:In this study total of 40 patients were operated on for low-grade spondylolisthesis by posteriorstabilization using a pedicular screw rod system and posterior lumbar interbody fusion. All thepatients were followed up till 6 months after surgery and functional outcomes were noted. Results:Assessment of this series it was observed that, 57.5% of the patient had excellent outcome, 37.5%had a good outcome and 97.5% of the study population had satisfactory outcome (improvement inclinical results). There was a significant improvement in pain intensity, walking, lifting, standing,sleeping after surgery. The mean ODI difference between preoperative and post-operative at 6months follow up was 36.12% (16.75). In the outcome, 62.5% of the patient consisted of severedisability and 32.5% were with moderate disability (total-95%) while postoperative 87.5% were witha minimal disability and only 2.5% of the study population had worsened i.e crippled. Conclusion:The study concluded that surgery in form of decompression with instrumentation and posteriorlumbar interbody is a safe and effective method to treat spondylolisthesis.

scholarly journals A comparative study of functional outcome between posterior lumbar fusion and posterior lumbar interbody fusion in spondylolisthesis

2021 ◽  
Vol 7 (3) ◽  
pp. 544
Author(s):  
Harpreet Singh ◽  
Dhruv Patel ◽  
Sangam Tyagi ◽  
Krushna Saoji ◽  
Tilak Patel ◽  
...  
Keyword(s):  
Functional Outcome ◽  
Interbody Fusion ◽  
Operative Time ◽  
Lumbar Fusion ◽  
Tertiary Care ◽  
Posterior Lumbar Interbody Fusion ◽  
Invasive Technique ◽  
Lumbar Interbody Fusion ◽  
Tertiary Care Centre ◽  
Posterior Lumbar Fusion

<p class="abstract"><strong>Background:</strong> Spondylolisthesis is condition in which one vertebra slips over other vertebra. This study has been done to compare the functional outcome and complications of two techniques: posterior lumbar fusion (intertransverse fusion) and posterior lumbar interbody fusion.</p><p class="abstract"><strong>Methods:</strong> Total 20 patients with spondylolisthesis admitted in a tertiary care centre in Rajasthan were allotted alternatively in posterior lumbar fusion (PLF) group and posterior lumbar interbody fusion (PLIF) group. In PLF, fusion was done by placing bone graft between transverse processes and around facets. In PLIF, fusion was bone by placing cage in between vertebral bodies.</p><p class="abstract"><strong>Results:</strong> 20 patients were included in our study with female predominance (65%). Mean age was 54.2 years (PLF=58.4 and PLIF=50.2). 70% patients have L4-L5 level spondylolisthesis. Average operative time was less in PLF group, which is statistically significant. Functional outcome was measured by using visual analogue scale (VAS) score and Japanese orthopedics association score (JOAS) at 3 weeks, 3 months and 6 months. There is a significant decrease between preoperative VAS and at 6 months, in both PLF and PLIF group. JOAS was significantly increased at 6 months in both PLF and PLIF group as compared to preoperative score. But difference in JOAS at 6 months is not significant between PLF and PLIF.</p><p class="abstract"><strong>Conclusions:</strong> Both PLF and PLIF are equally effective for spondylolisthesis. Both techniques have same satisfactory results. As PLIF is more invasive technique, more operative time and more complications are seen.</p>

scholarly journals Threaded cortical bone dowels for lumbar interbody fusion: technique and short-term results

1999 ◽  
Vol 7 (6) ◽  
pp. E8 ◽  
Author(s):  
Bryan Barnes ◽  
Mark R. McLaughlin ◽  
Barry Birch ◽  
Gerald E. Rodts ◽  
Regis W. Haid
Keyword(s):  
Cortical Bone ◽  
Interbody Fusion ◽  
Pedicle Screws ◽  
Posterior Lumbar Interbody Fusion ◽  
Low Back ◽  
Lumbar Interbody Fusion ◽  
Nerve Root Injury ◽  
Satisfactory Outcome ◽  
Bone Dowels

The authors retrospectively reviewed a series of cases involving mechanical low-back or disogenic pain; 35 patients underwent lumbar interbody fusion in which threaded cortical bone dowels (TCBDs) were placed to treat degenerative disc disease. The series was composed of 18 females, and 17 males whose mean age was 46 years (range 17-76 years). There were nine smokers in the group. All patients presented with symptoms consistent with mechanical low-back or discogenic pain, and magnetic resonance imaging–documented degenerative changes and disc collapse greater than 50%, as compared with the adjacent normal-appearing level, were confirmed. Twenty-three patients underwent a posterior lumbar interbody fusion (PLIF) procedure for placement of the TCBD, whereas 12 underwent an anterior lumbar interbody fusion (ALIF) procedure for placement of the TCBD. In all patients undergoing PLIF procedures pedicle screw and rod constructs were used without posterolateral fusion except one. In all cases of ALIF except one TCBDs were used as “stand-alone” devices without supplemental fixation. All TCBDs were packed with morselized cancellous autograft prior to implantation. The success of fusion was determined at follow-up intervals and was defined as: the absence of lucency around the TCBD; an increase in subchondral endplate sclerosis; and the presence of bridging bone incorporating the anterior bone graft as demonstrated on static lumbar radiographs and/or computerized tomography scans. Stability was also determined by an absence of movement on dynamic lumbar radiographs. The degree of lumbar lordosis at the diseased level was measured immediately postoperatively and compared with the change in lordosis at follow up. Outcomes were assessed using a modified Prolo outcome scale and rated as excellent, good, fair, or poor. Excellent and good outcomes were considered satisfactory; fair or poor outcomes were considered unsatisfactory. In 27 patients radiographic and clinical follow-up results were considered adequate (nine ALIF and 18 PLIF patients). The mean follow-up duration was 7.9 months. Overall satisfactory outcome was 70%: a 77% satisfactory outcome in PLIF patients and a 55% in ALIF patients. Osseous fusion was present in 94% of the patients in the PLIF group and in 33% of those in the ALIF group. Complications included one L-5 nerve root injury and two postoperative wound infections, all in patients who underwent PLIF; there was also a case of breakout of one implant at 8 months postoperatively. The degree of vertebral body angulation measured at last follow up compared with the measurement obtained immediately postoperative was 3.4° of kyphosis in the ALIF group and 3.1° of kyphosis in the PLIF group, which represented an 11% and 9% loss of lordosis, respectively. Preliminary results indicate that there is a dramatically higher fusion rate in PLIF compared with ALIF procedures in which TCBDs are used. There is a corresponding trend seen in patient outcomes, but no distinct difference seems apparent in terms of restoration of lordosis when performing either procedure. The results suggest that TCBDs may best be used in PLIF procedures in conjunction with pedicle screws and rod constructs. Moreover, in patients in whom TCBDs and supplemental tension band constructs are used fusion rates appear to be comparable with those reported in other series but at a faster rate (94% at 7.9 months mean follow up). Longer follow-up periods and a larger series of patients are needed to confirm these preliminary observations.

scholarly journals Dynamic Stabilization Adjacent to Fusion versus Posterior Lumbar Interbody Fusion for the Treatment of Lumbar Degenerative Disease: A Meta-Analysis

2020 ◽  
Vol 2020 ◽  
pp. 1-19
Author(s):  
Xiangyao Sun ◽  
Zhaoxiong Chen ◽  
Siyuan Sun ◽  
Wei Wang ◽  
Tongtong Zhang ◽  
...  
Keyword(s):  
Functional Outcome ◽  
Interbody Fusion ◽  
Posterior Lumbar Interbody Fusion ◽  
Reoperation Rate ◽  
Adjacent Segment ◽  
Lumbar Interbody Fusion ◽  
Hybrid Surgery ◽  
Lumbar Degenerative Disease ◽  
Topping Off

This study evaluated differences in outcome variables between dynamic stabilization adjacent to fusion (DATF) and posterior lumbar interbody fusion (PLIF) for the treatment of lumbar degenerative disease. A systematic review of PubMed, EMBASE, and Cochrane was performed. The variables of interest included clinical adjacent segment pathologies (CASPs), radiological adjacent segment pathologies (RASPs), lumbar lordosis (LL), visual analogue scale (VAS) of back (VAS-B) and leg (VAS-L), Oswestry disability index (ODI), Japanese Orthopaedic Association (JOA) score, duration of surgery (DS), estimated blood loss (EBL), complications, and reoperation rate. Nine articles identified as meeting all of the inclusion criteria. DATF was better than PLIF in proximal RASP, CASP, and ODI during 3 months follow-up, VAS-L. However, no significant difference between DATF and PLIF was found in distal RASP, LL, JOA score, VAS-B, ODI after 3 months follow-up, complication rates, and reoperation rate. These further confirmed that DATF could decrease the proximal ASP both symptomatically and radiographically as compared to fusion group; however, the influence of DATF on functional outcome was similar with PLIF. The differences between hybrid surgery and topping-off technique were located in DS and EBL in comparison with PLIF. Our study confirmed that DATF could decrease the proximal ASP both symptomatically and radiographically as compared to the fusion group; however, the influence of DATF on functional outcome was similar with PLIF. The difference between hybrid surgery and topping-off technique was not significant in treatment outcomes.

scholarly journals Functional and radiological analysis of posterior lumbar interbody fusion in spondylolisthesis

2015 ◽  
Vol 1 (1) ◽  
pp. 11
Author(s):  
Ramanujam Muthu Manickam ◽  
Ganesan G. Ram ◽  
S. Sundar ◽  
A. Prakash
Keyword(s):  
Pedicle Screw ◽  
Interbody Fusion ◽  
Surgical Intervention ◽  
Degenerative Spondylolisthesis ◽  
Posterior Lumbar Interbody Fusion ◽  
Low Grade ◽  
Lumbar Interbody Fusion ◽  
Isthmic Spondylolisthesis ◽  
The Mean

<p class="abstract"><strong><span lang="EN-US">Background:</span></strong>Spondylolisthesis is present in 5% of the adult population with clinical evidence of low back pain. These patients are treated initially by conservative measures, failing of which surgical intervention is mandatory. Majority of patients with varying degree of slip and disability ultimately require surgical intervention. In this study we are trying to analyse the functional outcome following posterior lumbar interbody fusion in spondylolisthesis.</p><p class="abstract"><strong><span lang="EN-US">Methods:</span></strong><span lang="EN-US"> Posterior lumbar interbody fusion using pedicle screw and rods with cage was performed on 25 patients. 6 months follow-up was completed in 25 patients who were then reviewed at regular intervals. Out of the 25 patients, 17(68%) were females and 8(32%) were males. The mean age of the patients was 40.64 years. Out of 25 patients, 14 patients had listhesis at L4 – L5 level and another 11 at L5 – S1 level. 21(84%) were Isthmic variant and 4 (16%) were Degenerative spondylolisthesis.<strong></strong></span></p><p class="abstract"><strong><span lang="EN-US">Results:</span></strong>The mean follow up period in this study of 25 patients is 19 months. Out of 25 patients, there was mean improvement of 18.96 in the Oswestry scoring index. The Visual analogue scale score showed a mean improvement of 6.48. Radiologically, the percentage of slip was decreased by a mean of 8.40%. One patient had a cage extrusion with no neurological deficit.</p><p class="abstract"><strong><span lang="EN-US">Conclusions:</span></strong>The pedicle screw with rod and cage system is easy to use and provides the anatomic restoration of the isthmus in isthmic spondylolisthesis or restoring the stability after laminectomy/discectomy in degenerative spondylolisthesis. From our study, we strongly believe that this technique is very useful in low grade degenerative and isthmic spondylolisthesis.</p>

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