Uninstrumented posterolateral spinal arthrodesis: is it the gold standard technique for I degrees and II degrees grade spondylolisthesis in adolescence?

Abstract

We retrospectively reviewed the outcome of uninstrumented posterolateral spinal arthrodesis in 49 patients with lumbar isthmic spondylolisthesis grades I degrees and II degrees in adolescent patients in the time of surgery, who participate at follow-up, between 1980 and 1995. The goal of our study is to analyse the clinical and radiographic imaging at long follow-up in uninstrumented posterolateral arthrodesis and to evaluate the efficiency and the validity of surgical technique in young patients (<18 years). All patients had failed previous conservative treatment. The average age at follow-up was 33.5 years (range 25-42 years) and the average follow-up time was 19.7 years (range 12-27 years). The clinical outcome measures were the Oswestry Disability Index, the SF-36, and the visual analogic score. All measures assessed the endpoint outcomes at 20 years after surgery. The outcome of spinal fusion was good with 43 (87.7%) patients attaining solid fusion, pseudoarthrosis in 6 patients (12.3%). None of our patients complained of excessive postoperative wound pain. Additionally, no complications, such as wound infection, were encountered. Satisfactory results were obtained in 94% of patients and this was closely associated with the rate of successful fusion. The results suggest that clinical outcome is closely related to the attainment of solid fusion.

• Authors: M Girardo, N Bettini, E Dema, S Cervellati
• Journal: European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society (Eur Spine J) Vol. 18 Suppl 1 Pg. 126-32 (Jun 2009) ISSN: 1432-0932 [Electronic] Germany
• PMID: 19415344 (Publication Type: Journal Article)

Topics

• Adult
• Age Factors
• Aging (physiology)
• Disability Evaluation
• Disease Progression
• Female
• Humans
• Lumbar Vertebrae (growth & development, pathology, surgery)
• Male
• Middle Aged
• Outcome Assessment, Health Care
• Pain, Postoperative (epidemiology)
• Postoperative Complications (diagnostic imaging, epidemiology, pathology)
• Pseudarthrosis (diagnostic imaging, epidemiology, pathology)
• Radiography
• Retrospective Studies
• Severity of Illness Index
• Spinal Fusion (methods, standards, statistics & numerical data)
• Spondylolisthesis (diagnostic imaging, pathology, surgery)
• Surgical Wound Infection (epidemiology)
• Treatment Outcome