Surgical Treatment of Isthmic Spondylolisthesis: Pedicle Screw Fixation, Posterolateral Fusion, and Posterior Lumbar Interbody Fusion with Cage after Wide Decompression

2003 ◽  
Vol 10 (2) ◽  
pp. 119 ◽  
Author(s):  
Hwa-Yeop Na ◽  
You-Young Jeong ◽  
Woo-suk Kim ◽  
Hyoung-Wook Cho
Keyword(s):  
Surgical Treatment ◽  
Pedicle Screw ◽  
Interbody Fusion ◽  
Screw Fixation ◽  
Posterior Lumbar Interbody Fusion ◽  
Pedicle Screw Fixation ◽  
Posterolateral Fusion ◽  
Lumbar Interbody Fusion ◽  
Isthmic Spondylolisthesis

Pedicle screw fixation for isthmic spondylolisthesis: does posterior lumbar interbody fusion improve outcome over posterolateral fusion?

2003 ◽  
Vol 99 (2) ◽  
pp. 143-150 ◽  
Author(s):  
Giovanni La Rosa ◽  
Alfredo Conti ◽  
Fabio Cacciola ◽  
Salvatore Cardali ◽  
Domenico La Torre ◽  
...  
Keyword(s):  
Interbody Fusion ◽  
Lumbar Fusion ◽  
Posterior Lumbar Interbody Fusion ◽  
Fusion Rate ◽  
Pedicle Screw Fixation ◽  
Posterolateral Fusion ◽  
Lumbar Interbody Fusion ◽  
Isthmic Spondylolisthesis ◽  
Content Type ◽  
Fine Print

Object. Posterolateral fusion involving instrumentation-assisted segmental fixation represents a valid procedure in the treatment of lumbar instability. In cases of anterior column failure, such as in isthmic spondylolisthesis, supplemental posterior lumbar interbody fusion (PLIF) may improve the fusion rate and endurance of the construct. Posterior lumbar interbody fusion is, however, a more demanding procedure and increases costs and risks of the intervention. The advantages of this technique must, therefore, be weighed against those of a simple posterior lumbar fusion. Methods. Thirty-five consecutive patients underwent pedicle screw fixation for isthmic spondylolisthesis. In 18 patients posterior lumbar fusion was performed, and in 17 patients PLIF was added. Clinical, economic, functional, and radiographic data were assessed to determine differences in clinical and functional results and biomechanical properties. At 2-year follow-up examination, the correction of subluxation, disc height, and foraminal area were maintained in the group in which a PLIF procedure was performed, but not in the posterolateral fusion—only group (p < 0.05). Nevertheless, no statistical intergroup differences were demonstrated in terms of neurological improvement (p = 1), economic (p = 0.43), or functional (p = 0.95) outcome, nor in terms of fusion rate (p = 0.49). Conclusions. The authors' findings support the view that an interbody fusion confers superior mechanical strength to the spinal construct; when posterolateral fusion is the sole intervention, progressive loss of the extreme correction can be expected. Such mechanical insufficiency, however, did not influence clinical outcome.

Posterior Lumbar Interbody Fusion: With and Without Pedicle Screw Fixation

1993 ◽  
pp. 188-196 ◽  
Author(s):  
Sadaaki Nakai ◽  
Hidezo Yoshizawa ◽  
Kazuhiko Kenmotsu ◽  
Satoshi Nishimoto ◽  
Tomofumi Morita
Keyword(s):  
Pedicle Screw ◽  
Interbody Fusion ◽  
Screw Fixation ◽  
Posterior Lumbar Interbody Fusion ◽  
Pedicle Screw Fixation ◽  
Lumbar Interbody Fusion
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