What to consider in degenerative spondylolisthesis: posterolateral fusion or transforaminal interbody fusion

2017 ◽  
Vol 2 ◽  
pp. 142-142
Author(s):  
Hitesh N. Modi ◽  
Shakti A. Goel
Keyword(s):  
Interbody Fusion ◽  
Degenerative Spondylolisthesis ◽  
Posterolateral Fusion ◽  
Transforaminal Interbody Fusion

Predicting spondylolisthesis correction with prone traction radiographs

2020 ◽  
Vol 102-B (8) ◽  
pp. 1062-1071 ◽  
Author(s):  
Jason P. Y. Cheung ◽  
Ho Ken Fong ◽  
Prudence W. H. Cheung
Keyword(s):  
Interbody Fusion ◽  
Degenerative Spondylolisthesis ◽  
Information Criterion ◽  
Disc Height ◽  
Posterolateral Fusion ◽  
Slip Angle ◽  
Level Of Evidence ◽  
Flexion Extension ◽  
Segmental Lordosis ◽  
Slip Distance

Aims To determine the effectiveness of prone traction radiographs in predicting postoperative slip distance, slip angle, changes in disc height, and lordosis after surgery for degenerative spondylolisthesis of the lumbar spine. Methods A total of 63 consecutive patients with a degenerative spondylolisthesis and preoperative prone traction radiographs obtained since 2010 were studied. Slip distance, slip angle, disc height, segmental lordosis, and global lordosis (L1 to S1) were measured on preoperative lateral standing radiographs, flexion-extension lateral radiographs, prone traction lateral radiographs, and postoperative lateral standing radiographs. Patients were divided into two groups: posterolateral fusion or posterolateral fusion with interbody fusion. Results The mean changes in segmental lordosis and global lordosis were 7.1° (SD 6.7°) and 2.9° (SD 9.9°) respectively for the interbody fusion group, and 0.8° (SD 5.1°) and -0.4° (SD 10.1°) respectively for the posterolateral fusion-only group. Segmental lordosis (ρ = 0.794, p < 0.001) corrected by interbody fusion correlated best with prone traction radiographs. Global lumbar lordosis (ρ = 0.788, p < 0.001) correlated best with the interbody fusion group and preoperative lateral standing radiographs. The least difference in slip distance (-0.3 mm (SD 1.7 mm), p < 0.001), slip angle (0.9° (SD 5.2°), p < 0.001), and disc height (0.02 mm (SD 2.4 mm), p < 0.001) was seen between prone traction and postoperative radiographs. Regression analyses suggested that prone traction parameters best predicted correction of slip distance (Corrected Akaike’s Information Criterion (AICc) = 37.336) and disc height (AICc = 58.096), while correction of slip angle (AICc = 26.453) was best predicted by extension radiographs. Receiver operating characteristic (ROC) cut-off showed, with 68.3% sensitivity and 64.5% specificity, that to achieve a 3.0° increase in segmental lordotic angle, patients with a prone traction disc height of 8.5 mm needed an interbody fusion. Conclusion Prone traction radiographs best predict the slip distance and disc height correction achieved by interbody fusion for lumbar degenerative spondylolisthesis. To achieve this maximum correction, interbody fusion should be undertaken if a disc height of more than 8.5 mm is attained on preoperative prone traction radiographs. Level of Evidence: Level II Prognostic Study Cite this article: Bone Joint J 2020;102-B(8):1062–1071.

scholarly journals Posterolateral Fusion Versus Interbody Fusion for Degenerative Spondylolisthesis: Systematic Review and Meta-Analysis

2017 ◽  
Vol 7 (5) ◽  
pp. 482-490 ◽  
Author(s):  
Ryan C. Campbell ◽  
Ralph J. Mobbs ◽  
Victor M. Lu ◽  
Joshua Xu ◽  
Prashanth J. Rao ◽  
...  
Keyword(s):  
Systematic Review ◽  
Interbody Fusion ◽  
Meta Analysis ◽  
Degenerative Spondylolisthesis ◽  
Posterolateral Fusion
Sign in / Sign up

Export Citation Format

Share Document