Degenerative Spondylolisthesis

Feffer, Henry L.; Wiesel, Sam W.; Cuckler, John M.; Rothman, Richard H.

doi:10.1097/00007632-198504000-00018

Cited by 122 publications

(39 citation statements)

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“…However, the overall complication rate was not statistically significant between the two groups. Some authors consider the PLIF procedure difficult due to the increased bleeding, prolonged operation time, and more extensive dissection 7,8 . The reported complications associated with the PLIF procedure include: permanent neurological deficit in 0.4 to 1.7%; CSF leak in 0.4 to 0.5%; radicular pain in 1.1 to 2,5%; posterior displacement of the cage in 0.8 to 0.9%; deep wound infection in 0.6 to 5.0% [27][28][29] .…”

Section: Discussionmentioning

confidence: 99%

“…Preoperative mean Rolland-Morris questionnaire score in Group I was 11.2 (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20). The mean post-operative score was 7.4 (1-22).…”

Section: Group II (Plif) -mentioning

confidence: 99%

“…It occurs in up to 5% of the general population and affects all ages 2 . The surgical treatment of spondylolisthesis is indicated for cases of neurogenic claudication, intractable radicular pain, severe low-back pain, presence of neurological symptoms, failure of conservative management, radiological instability, progressive worsening of the listheses, Meyerding grade III and Iv listheses, and spondyloptosis [3][4][5] .The ideal surgical treatment remains controversial [6][7][8] .…”

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confidence: 99%

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Comparison between posterior lumbar fusion with pedicle screws and posterior lumbar interbody fusion with pedicle screws in adult spondylolisthesis

Dantas

Prandini

Ferreira

2007

Arq. Neuro-Psiquiatr.

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-The purpose of this study was to compare patients with lumbar spondylolisthesis submitted to two different surgical approaches, and evaluate the results and outcomes in both groups. In a two-year period, 60 adult patients with lumbar spondylolisthesis, both isthmic and degenerative, were submitted to surgery at the Biocor Institute, Brazil. All patients were operated on by the same surgeon (FLRD) in a single institution, and the results were analyzed prospectively. Group I comprised the first 30 consecutive patients that were submitted to a posterior lumbar spinal fusion with pedicle screws (PLF). Group II comprised the last 30 consecutive patients submitted to a posterior lumbar interbody fusion procedure (PLIF) with pedicle screws. All patients underwent foraminotomy for nerve root decompression. Clinical evaluation was carried out using the Prolo Economic and Functional Scale and the Rolland-Morris and the Oswestry questionnaire. Mean age was 52.4 for Group I (PLF), and 47.6 for Group II (PLIF). The mean follow-up was 3.2 years. Both surgical procedures were effective. The PLIF with pedicle screws group presented better clinical outcomes. Group I presented more complications when compared with Group II. Group II presented better results as indicated in the Prolo Economic and Functional Scale.KEy wORDS: posterior lumbar interbody fusion (PLIF), posterior lumbar fusion, spondylolisthesis, pedicle screws, lumbar spine, spinal instrumentation.estudo comparativo entre fusão lombar posterior com parafuso pedicular e fusão intersomáti-ca lombar posterior associada com parafuso pedicular em espondilolistese no adulto RESUMO -O objetivo foi comparar dois grupos de pacientes portadores de espondilolistese lombar que foram submetidos a dois procedimentos cirúrgicos distintos, avaliando os resultados clínicos levando em consideração a qualidade de vida. Durante o período de 1998 a 2001 sessenta pacientes portadores de espondilolistese da coluna lombar ístmica e degenerativa foram submetidos a tratamento cirúrgico no Hospital Biocor em Belo Horizonte, por um mesmo cirurgião foram analisados prospectivamente. Os primeiros trinta pacientes foram submetidos a fusão posterior com parafusos pediculares e os trinta seguintes a fusão posterior com parafusos pediculares associada a fusão intersomática posterior. Os pacientes foram submetidos a liberação radicular com laminectomia e foraminotomia. A avaliação clínica foi feita utilizando as escalas de Prolo Econômico e Funcional, o questionário de Rolland-Morris e de Oswestry. Os resultados clínicos apresentaram que os dois procedimentos realizados foram eficazes. Houve maior número de complicações relacionadas com a biomecânica no grupo que foi submetido somente à fusão posterior e o grupo submetido à fusão posterior associada a fusão intersomática apresentou melhores resultados com retorno as atividades diárias e melhora da qualidade de vida.PALAvRAS-CHAvE: fusão intersomática lombar posterior, fusão lombar posterior, espondilolistese, fixação pedicular, coluna lombar,...

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Section: Discussionmentioning

confidence: 99%

“…Preoperative mean Rolland-Morris questionnaire score in Group I was 11.2 (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20). The mean post-operative score was 7.4 (1-22).…”

Section: Group II (Plif) -mentioning

confidence: 99%

mentioning

confidence: 99%

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Comparison between posterior lumbar fusion with pedicle screws and posterior lumbar interbody fusion with pedicle screws in adult spondylolisthesis

Dantas

Prandini

Ferreira

2007

Arq. Neuro-Psiquiatr.

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“…The surgical treatment of degenerative spondylolisthesis includes decompression [2,16] and decompression and fusion, with or without internal fixation [8,15,21]. The criteria for choosing the most appropriate treatment have not been determined, though it would be important to identify which sub-group of patients may be treated with decompression alone, considering the morbidity associated with fusion [19,20], particularly when this is supplemented with internal fixation [4,23,31].…”

Section: Discussionmentioning

confidence: 99%

Predisposing factors in degenerative spondylolisthesis

Cinotti¹,

Postacchini

Fassari

et al. 1997

International Orthopaedics

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Summary. We report a prospective study analysing whether possible factors predisposing to degenerative spondylolisthesis (DS) must be present concomitantly in order to cause vertebral slipping. Standard and flexion-extension radiographs were obtained from 27 patients with DS and 27 without spondylolisthesis. The level of the intercrestal line, the lumbosacral angle, the presence of sacralization of L5 and vertebral motion at the L4 ± L5 level were assessed. Facet joint orientations were measured on CT scans. Only facet joint orientation and vertebral motion at the spondylolisthetic level were significantly different in patients with DS compared with controls. Facet joints were oriented more sagittally both at the spondylolisthetic level and at the levels above and below. An inverse linear correlation was found between the sagittal orientation of facet joints and the mobility of the slipped vertebra. Abnormal sagittal orientation of facet joints and hypermobility of the spondylolisthetic vertebra appear to play major roles among possible factors predisposing to DS. Both factors should be considered in the planning of surgical treatment.

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“…[14][15][16][17][18][19][20][21] Instrumented PLF has long been widely accepted as the standard method for vertebral fusion for treating spinal instability and for restoring spinal alignment, [6,7,29,30] but failure of fusion and pseudoarthrosis are common in this method. [15][16][17][18][19][20][21] Use of a combination of anterior and posterior fusion in the 1990s (severity of displacement was 22% and 13% in the flexion and extension positions, respectively); no rigid or dynamic kyphosis was observed.…”

Section: Discussionmentioning

confidence: 99%