Surgical Outcome Of Lumbar Degenerative Spondylolisthesis With Reduction Versus Fusion In Situ.

Abstract

Background:

Surgical approaches used in the treatment of patients with severe lumbar spondylolisthesis( Grade II and Grade III)are usually associated with a great deal of controversies. The objective of the study was to assessthe surgicaloutcomes of severe Lumbar spondylolisthesis treated with either pedicle screw fixation,reduction and fusion or instrumented Fusion in-situ.

Methods:

We retrospectively studied 32 patients (20 females and 12males),whohadsevere lumbar spondylolisthesis. All patients were divided in two groups (group Areduction and fusionand group B fusion in-situ).The mean follow-up period was 6 months. Radiological and clinical outcomes were measured by slip percentage, slip angle correction rate, Oswestry Disability index(ODI), visual analogue scale (VAS). Data was analyzed by SPSS version 22.0

Results:

The analysis of the preoperative visits and final follow-up of all patients indicated that vertebral reduction and fusioncould slightly enhance the surgicaloutcome in comparison to instrumentedfusion in situ. Preoperative and Postoperative data was collected in all patients and found VAS from7.76to 2.08 in group-A and VAS from 8.5 preoperative to 2.4 postoperative in group-B and ODI from69.42% to 20.06 % in group-Aand 70.9% to 22% in group-B and mean slipcorrection rate was59.8 % . There wasno single caseof loss of reduction.

Conclusion:

The reduction, fusion and spinal decompression enhances surgical outcome and it can be concluded thatsuch procedure is slightly superior over fusionin situ.Excellent and good levels of satisfaction were observed in all group-A patients,although surgical time was slightly more than fusion in-situ group.