Clinical and Radiological Outcome in Cases of Posterolateral Fusion with Instrumentation for Lumbar Spondylolisthesis

Nayak, Madhukar; Sannegowda, Raghavendra Bakki

doi:10.7860/jcdr/2015/11530.6077

Cited by 6 publications

(8 citation statements)

References 4 publications

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“…In our study there was no significant difference between both groups in ODI score but the VAS for back pain was significantly improved in group B than in group A. The fusion rate was higher and successful in group B than in group A so we agree with the results of Nayak and Raghavendra, 21 as they concluded that a successful fusion usually associated with improvement in back and lower limb symptoms with better patient satisfaction. Durate et al, 11 evaluated the impact of BMI on the clinical outcome in their study and they reported that there were no significant differences in ODI score (functional state) after surgery between the two groups (BMI³30&BMI<30).…”

Section: Discussionsupporting

confidence: 88%

Posterolateral Fusion versus Transforaminal Lumbar Interbody Fusion in the Surgical Treatment of Low-Grade Isthmic Spondylolisthesis

Farid

Elkholy

2018

Egyptian Spine Journal

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Background Data: Surgical treatment of isthmic spondylolisthesis includes decompression, fixation and bone fusion. There are different suitable techniques for fusion as (PLF) posterolateral fusion (TLIF) transforaminal lumbar interbody fusion, (PLIF) posterior lumbar interbody fusion, (ALIF) anterior lumbar interbody fusion but still controversy remains about the best technique. Purpose: To evaluate and compare the surgical results of PLF versus TLIF with pedicle screw fixation in treatment of low-grade isthmic spondylolisthesis. Study design: A prospective randomized clinical case series. Patients and methods: This study included 40 patients with low grade isthmic spondylolisthesis. All patients were surgically treated by posterior decompression, transpedicular screw fixation and bone fusion. Patients were divided into two equal groups according to the type of bone fusion. Group A included 20 patients treated with PLF, and Group B included another 20 patients and were treated with TLIF. We used Visual Analogue Scale (VAS) for assess pain and the Oswestry Disability Index (ODI) to evaluate the functional outcome among our patients. Patients have been followed up for at least six months after surgery. Results: The improvement of VAS of back pain was significantly greater in group B (TLIF) (change 5.25±1.55) than in group A (PLF) (change, 4.4±1.14) (P<0.05). There was no significant difference in improvement of ODI in both groups. Patients with BMI³30 showed that group B experienced more clinical improvement than in group A in the VAS (P=0.021). The operative time in group B (185±24.5 min) was significantly longer than in group A (123.3±19.6 min) (P=0.034). Intraoperative blood loss in group B (584±192.1 ml) was significantly greater than in group A (417±182.4 ml) (P=0.008). The complication rate in group A (30%) was significantly less than in group B (55%) (P= 0.032) but broken screws (hardware failure) were more common in group A (20%) than in group B (0.0%) (P=0.01). The fusion rate in group B (95%) was higher than in group A (75%). Conclusion: Our data suggest that although TLIF is better than PLF in achievement of successful bone fusion and improvement of patient's symptoms (back pain and sciatica), PLF still considered simple technique with minimal operative blood loss, less operative time and little complications. (2018ESJ162)

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Section: Discussionsupporting

confidence: 88%

Posterolateral Fusion versus Transforaminal Lumbar Interbody Fusion in the Surgical Treatment of Low-Grade Isthmic Spondylolisthesis

Farid

Elkholy

2018

Egyptian Spine Journal

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“…When looking at the studies related to posterior fixation and fusion in the literature, a significant improvement was seen in VAS and ODI scores of patients in the early and medium term (18)(19)(20). In our study, when the ODI and VAS scores of the patients with fusion and non-fusion were compared in the preoperative and postoperative periods, the ODI and VAS scores were statistically significantly lower in the postoperative period than the preoperative period.…”

Section: Discussionmentioning

confidence: 77%

Short and Medium Term Results of Posterior Segmental Instrumentation and Posterolateral Fusion in Female Patients with Spondylolisthesis: A Clinical Trial

Kızılay¹,

Topçu²,

Aydin³

et al. 2018

meandros

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Objective: Aim of this study was to short and medium term results of posterior segmental instrumentation and posterolateral fusion in female patients with spondylolisthesis. Materials and methods:Patients with lumbar sponylolisthesis who were performed convetional laminectomy, poliaxial secrew fixation and posterolateral fusion between the 2013 and 2015. The postoperative fusion of the female patients were evaluated through Lumbar 3D Computed Tomography and X-Ray imaging. The patients' low back pain and lower extremities's pain were evaluated with Oswestry disability index and Visual Analogue Score. Retrospective Patients' information were collected via file in May 2016. Result: When the pain scores of the patients who underwent segmental instrumentation were compared in the preoperative, postoperative periods there was the significant decrease in pain scores (p<0.001). Conclusion:The posterolateral fixation and fusion are an efficient treatment method in the medium and short term in female patients with spondylolisthesis. But, a secondary chronic disease such as osteoporosis associated with aging was added to impair bone quality, fusion success rate was seen to be decreased.

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“…It has been stated that decompression mainly relieves radicular symptoms and neurogenic claudication, while fusion primarily relieves back pain by stabilizing the spine. Also, the addition of instrumentation leads to a solid arthrodesis [ 1 ]. Specifically, among patients with degenerative spondylolisthesis, the addition of lumbar spinal fusion to laminectomy has been associated with greater clinically improvement in overall physical health-related quality of life than laminectomy alone [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

“…However, both surgical fusion techniques (PLF and PLIF) appear to lessen the disability of patients with spondylolisthesis, and none of the fusion techniques has been related to a better outcome in terms of disability [ 10 ]. Taking under evaluation the satisfaction rate, physical function and radiological factors (bony fusion/pseudarthrosis), in a similar group of patients, decompression and PLF is proposed as the procedure of choice for degenerative lumbar listhesis, with the limitation of the short (6 months) follow up and the retrospective character of the study [ 1 ]. Concerning the type of spondylolisthesis, Omidi-Kashani et al compared the radiological and clinical outcomes (VAS and ODI scores) of patients suffering from isthmic and degenerative spondylolisthesis and the results revealed that decompression and PLF improve significantly both pain and disability in both groups of patients [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

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Postoperative Evaluation of Health-Related Quality-of-Life (HRQoL) of Patients With Lumbar Degenerative Spondylolisthesis After Instrumented Posterolateral Fusion (PLF): A prospective Study With a 2-Year Follow-Up

Kapetanakis

Gkasdaris

Thomaidis

et al. 2017

TOORTHJ

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Background:Several studies have compared instrumented PLF with other surgical approaches in terms of clinical outcomes, however little is known about the postoperative HRQoL of patients, especially as regards to degenerative spondylolisthesis.Methods:A group of 62 patients, 30 women (48,4%) and 32 men (51,6%) with mean age 56,73 (SD +/- 9,58) years old, were selected to participate in a 2-year follow-up. Their pain was assessed via the visual analogue scale (VAS) for low back pain (VASBP) and leg pain (VASLP) separately. Their HRQoL was evaluated by the Short Form (36) Health Survey (SF-36). Both scales, VAS and SF36, were measured and re-assessed at 10 days, 1 month, 3 months, 6 months, 12 months and 2 years.Results:VASBP, VASLP and each parameter of SF36 presented statistically significant improvement (p<0.01). VASBP, VASLP and SF36 scores did not differ significantly between men and women (p≥0.05). The most notable amelioration of VASBP, VASLP was observed within the first 10 days and the maximum improvement within the first 3 months. From that point, a stabilization of the parameters was observed. The majority of SF36 parameters, and especially PF (physical functioning) and BP (bodily pain), presented statistically significant improvement within the follow up depicting a very similar improvement pattern to that of VAS.Conclusion:We conclude that instrumented PLF ameliorates impressively the HRQoL of patients with degenerative spondylolisthesis after 2 years of follow-up, with pain recession being the most crucial factor responsible for this improvement.

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Clinical and Radiological Outcome in Cases of Posterolateral Fusion with Instrumentation for Lumbar Spondylolisthesis

Cited by 6 publications

References 4 publications

Posterolateral Fusion versus Transforaminal Lumbar Interbody Fusion in the Surgical Treatment of Low-Grade Isthmic Spondylolisthesis

Posterolateral Fusion versus Transforaminal Lumbar Interbody Fusion in the Surgical Treatment of Low-Grade Isthmic Spondylolisthesis

Short and Medium Term Results of Posterior Segmental Instrumentation and Posterolateral Fusion in Female Patients with Spondylolisthesis: A Clinical Trial

Postoperative Evaluation of Health-Related Quality-of-Life (HRQoL) of Patients With Lumbar Degenerative Spondylolisthesis After Instrumented Posterolateral Fusion (PLF): A prospective Study With a 2-Year Follow-Up

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