One-stage posterior decompression-stabilization and trans-sacral interbody fusion after partial reduction for severe L5-S1 spondylolisthesis.

Abstract

STUDY DESIGN:

A retrospective clinical study was conducted.

OBJECTIVES:

To evaluate the clinical and radiologic outcomes of one-stage posterior decompression-stabilization after partial reduction and trans-sacral interbody fusion with a titanium cage for severe L5-S1 spondylolisthesis.

SUMMARY OF THE BACKGROUND DATA:

Trans-sacral interbody fusion for the management of severe L5-S1 spondylolisthesis with or without partial reduction and pedicular fixation has been previously described. The use of a trans-sacral titanium cage has not been previously reported.

METHODS:

Fifteen patients with severe L5-S1 spondylolisthesis were treated consecutively with posterior decompression, partial reduction, pedicular fixation, and posterior lumbar interbody fusion using a trans-sacral titanium cage. The mean age at the time of surgery was 22.4 years (range, 11-37 years). The mean follow-up period was 31.4 months (range, 12-58 months). Nine patients had severe back pain and six patients radicular pain. Three patients had a partial unilateral L5 motor deficit and two an L5 sensory deficit. Five patients had extremely tight hamstrings. The mean preoperative percentage of slipping was 69.3% (range, 53-91%). Patients were evaluated for complications and fusions, and outcomes were collected using the modified Scoliosis Research Society Outcomes Instrument.

RESULTS:

At follow-up, all patients, except one with major vascular complications, were extremely or reasonably satisfied with the surgery. All patients showed improvements in radiologic indexes and stable fusion at the final follow-up examination.

CONCLUSIONS:

Posterior decompression and partial reduction followed by circumferential stabilization performed in one stage combining pedicle fixation with trans-sacral titanium cage interbody fusion is an effective and safe technique for the management of severe spondylolisthesis.

• Authors: Pietro Bartolozzi, Andrea Sandri, Marco Cassini, Matteo Ricci
• Journal: Spine (Spine (Phila Pa 1976)) Vol. 28 Issue 11 Pg. 1135-41 (Jun 01 2003) ISSN: 1528-1159 [Electronic] United States
• PMID: 12782981 (Publication Type: Journal Article)

Chemical References

• Titanium

Topics

• Adolescent
• Adult
• Blood Loss, Surgical
• Child
• Decompression, Surgical (adverse effects)
• Female
• Follow-Up Studies
• Humans
• Internal Fixators
• Intraoperative Complications (etiology)
• Length of Stay
• Lumbosacral Region
• Patient Satisfaction
• Radiography
• Retrospective Studies
• Safety
• Spinal Fusion (adverse effects, instrumentation, methods)
• Spondylolisthesis (diagnostic imaging, surgery)
• Titanium
• Treatment Outcome