Adding Posterior Lumbar Interbody Fusion to Pedicle Screw Fixation and Posterolateral Fusion After Decompression in Spondylolytic Spondylolisthesis

Suk, Se Il; Lee, Choon-Ki; Kim, Won Joong; Lee, Ji Ho; Cho, Kyu Jung; Kim, Hyung Gook

doi:10.1097/00007632-199701150-00016

Cited by 282 publications

(184 citation statements)

References 28 publications

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“…In 30 patients, posterior lumbar interbody fusion (PLIF) using carbon cages (Nexis, Sofomor-Danek) filled with autograft was combined with posterolateral fusion at the time of initial surgery. The PLIF was used to enhance the solidity of fusion in patients thought to be at higher risk for pseudarthrosis, wide open disc space at the level of olisthesis, sagittal orientation of facet joints and significant mobility on the preoperative flexion/extension lateral radiographs of the lumbar spine [28]. The mean follow-up period was 5 years and the minimum follow-up was 2 years (range 2-12 years).…”

Section: Methodsmentioning

confidence: 99%

Correlation between sagittal plane changes and adjacent segment degeneration following lumbar spine fusion

Kumar¹,

2001

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IntroductionAdjacent segment degeneration (ASD) has been reported by many authors following lumbar and lumbosacral fusions [1,5,7,9,13,19,21,23,24,26,30,31,32]. In this study the term ASD is used to refer to the onset of degenerative changes in the previously normal disc spaces adjacent to the fusion segment. This becomes symptomatic in many cases and may need re-operation. It is well known that re-operations following lumbar fusions do not always carry good results and that the percentage of good results decreases with each revision surgery [4,11,16]. It is therefore essential to minimize the possibility of re-operation as much as possible. The reasons for adjacent segment degeneration are not fully understood as yet, although various causes have been speculated. The aim of this study is to examine the association of sagittal plane alterations with ASD.Abstract Adjacent segment degeneration following lumbar spine fusion remains a widely acknowledged problem, but there is insufficient knowledge regarding the factors that contribute to its occurrence. The aim of this study is to analyse the relationship between abnormal sagittal plane configuration of the lumbar spine and the development of adjacent segment degeneration. Eightythree consecutive patients who underwent lumbar fusion for degenerative disc disease were reviewed retrospectively. Patients with spondylolytic spondylolisthesis and degenerative scoliosis were not included in this study. Mean follow-up period was 5 years. Results were analysed to determine the association between abnormal sagittal configuration and post operative adjacent segment degeneration. Thirty-one out of 83 patients (36.1%) showed radiographic evidence of adjacent segment degeneration. Patients with normal C7 plumb line and normal sacral inclination in the immediate post operative radiographs had the lowest incidence of adjacent level change compared with patients who had abnormality in one or both of these parameters. The difference was statistically significant (P<0.02). There was no statistically significant difference in the incidence of adjacent level degeneration between male and female patients; between posterior fusion alone and combined posterolateral and posterior interbody fusions; and between fusions extending down to the sacrum and fusions stopping short of the sacrum. It was concluded was that normality of sacral inclination is an important parameter for minimizing the incidence of adjacent level degeneration. Retrolisthesis was the most common type of adjacent segment change. Patients with post operative sagittal plane abnormalities should preferably be followed-up for at least 5 years to detect adjacent level changes.

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Section: Methodsmentioning

confidence: 99%

Correlation between sagittal plane changes and adjacent segment degeneration following lumbar spine fusion

Kumar¹,

2001

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“…Union was defined as solid when there was bony trabecular continuity and less than 4°mobility between the segments on flexionextension stress radiographs [48]. The union was defined as probable when the bony trabecular continuity was not very clear but there was less than 4°mobility between the adjacent fused segments.…”

Section: Radiologic Evaluationmentioning

confidence: 99%

“…The union was defined as probable when the bony trabecular continuity was not very clear but there was less than 4°mobility between the adjacent fused segments. Nonunion was defined as a visible gap, graft collapse, and motion greater than 4° [48].…”

Section: Radiologic Evaluationmentioning

confidence: 99%

Comparison of instrumented anterior interbody fusion with instrumented circumferential lumbar fusion

Madan

Boeree

2003

European Spine Journal

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“…Reduction of the slip angle (lumbosacral kyphosis) allows direct neural decompression and improves the sagittal lumbosacral orientation. The main argument against reduction is that it involves more extensive surgery, and an increase risk for neurologic injury [2,25].…”

Section: Introductionmentioning

confidence: 99%

“In situ” fusion or reduction in high-grade high dysplastic developmental spondylolisthesis (HDSS)

2012

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Purpose To assess if the evaluation of the spino-pelvic balance can be effective in the surgical decision making of the high-grade high dysplastic developmental spondylolisthesis (HDDS). Methods Sixteen patients affected with high-grade HDDS (6 treated with ''in situ'' fusion, and 10 with reduction and fusion) were retrospectively evaluated. A clinical and radiological assessment of the deformity correction was carried out, with a minimum follow-up of 2 years. The differences between the pre-and postoperative measures were statistically analyzed using a two-tailed, paired t test. Results The six patients treated with ''in situ'' fusion showed no statistically significant change at the last followup relative to pelvic tilt (PT), sacral slope (SS), and grade, while the 10 patients treated with reduction showed significant changes: PT significantly decreased following surgery, while SS and grade significantly increased. Conclusions The analysis of the spino-pelvic sagittal balance allows to identify two types of HDDS: the balanced deformities, which do not need reduction, and the unbalanced deformities, in which correction is needed.

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Adding Posterior Lumbar Interbody Fusion to Pedicle Screw Fixation and Posterolateral Fusion After Decompression in Spondylolytic Spondylolisthesis

Abstract: The addition of posterior lumbar interbody fusion to posterolateral fusion after a complete decompression and pedicle screw fixation is a recommended procedure for the treatment of spondylolytic spondylolishesis with spinal stenosis.

Cited by 282 publications

References 28 publications

Correlation between sagittal plane changes and adjacent segment degeneration following lumbar spine fusion

Correlation between sagittal plane changes and adjacent segment degeneration following lumbar spine fusion

Comparison of instrumented anterior interbody fusion with instrumented circumferential lumbar fusion

“In situ” fusion or reduction in high-grade high dysplastic developmental spondylolisthesis (HDSS)

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