Radiological and functional outcomes of high-grade spondylolisthesis treated by intrasacral fixation, dome resection and circumferential fusion: a retrospective series of 20 consecutive cases with a minimum of 2 years follow-up

Ferrero, Emmanuelle; Ilharreborde, Brice; Mas, Virginie; Vidal, Christophe; Simon, Anne-Laure; Mazda, Keyvan

doi:10.1007/s00586-017-5455-2

Cited by 12 publications

(5 citation statements)

References 29 publications

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“…Therefore, reducing lumbosacral kyphosis and restoring sagittal alignment are major concerns during surgery for high-grade spondylolisthesis. 6 There was a significant reduction in L4 and L5 Severity Index values compared to the preoperative period. However, values remained > 20%, which shows the presence of pelvic retroversion.…”

Section: Discussionmentioning

confidence: 81%

The Lamartina Square and Severity Index in Surgery for High-Grade Lumbar Listhesis

et al. 2023

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Objective: evaluate the correlation between main sacropelvic alignment measurements and pelvic retroversion reduction and assessing Lamartina Square effectiveness in choosing the proximal instrumentation level. Methods: sample comprising 21 patients with high-grade L5 -S1 spondylolisthesis subjected to arthrodesis with instrumentation from January 2004 to December 2016. Patients’ demographic data, surgery type, complications, sagittal alignment parameters, Severity Index and Lamartina Square were recorded before surgery and in the last follow-up. Data processed in SPSS 22.0, with different means were calculated through Student’s t test, for paired data. Linear correlation analysis was performed based on Spearman’s coefficient. P <0.05 was statically significant. Results: there was significant improvement in the slip and Dubousset’s lumbosacral kyphosis angles (> 100° in the last postoperative follow-up). There was significant reduction of slip rate ( and in the L4 and L5 Severity Index, which highlighted strong correlation to pelvic tilt, mismatch and slip angle. Severity index also showed strong inverse correlation between Dubousset’s lumbosacral kyphosis angle and sacral slope. Conclusion: L5 Severity Index and Lamartina Square are important variables for preoperative planning of patients with high-grade lumbar spondylolisthesis. Level of Evidence IV; Case Series.

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Section: Discussionmentioning

confidence: 81%

The Lamartina Square and Severity Index in Surgery for High-Grade Lumbar Listhesis

et al. 2023

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“…10 In their series, Ferrero et al reported a 70% rate of postoperative neurological complications, the majority of which resolved within 3-6 months of surgery. 11 The Bohlman technique and its various modifications, including the reverse Bohlman technique, have gained traction over the last several years, [12][13][14][15][16] with varying results. For the most part, these techniques have involved decompression and in situ fusion, with little improvement in overall sagittal alignment.…”

Section: Discussionmentioning

confidence: 99%

“… 10 In their series, Ferrero et al reported a 70% rate of postoperative neurological complications, the majority of which resolved within 3–6 months of surgery. 11 …”

Section: Discussionmentioning

confidence: 99%

Restoration of sagittal alignment in high-grade isthmic spondylolisthesis using the reverse Bohlman technique with anterior lumbar interbody fusion using a hyperlordotic cage at L4–5: illustrative case

Ishmael

Arlet

Smith

2021

Journal of Neurosurgery: Case Lessons

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BACKGROUND Circumferential fusion with or without reduction is the preferred treatment for high-grade isthmic spondylolisthesis. Reduction presents significant risk of neurological injury. The authors present one case in which the “reverse Bohlman” technique was used with the addition of a hyperlordotic interbody cage at L4–5 as a means to correct sagittal malalignment while avoiding the reduction of L5 on S1. OBSERVATIONS The patient was a 22-year-old woman with a long-term history of lower back pain and bilateral L5 radiculopathy secondary to high-grade isthmic lumbar spondylolisthesis. She underwent anterior lumbar interbody fusion using the reverse Bohlman technique plus a hyperlordotic interbody cage at L4–5, followed by decompression and posterior spinal instrumentation and fusion from L4 to the pelvis. At 2-year follow-up, she was found to have complete resolution of symptoms with clinical and radiographic evidence of fusion. Her spinopelvic parameters had significantly improved. LESSONS The reverse Bohlman technique with the addition of a hyperlordotic interbody cage at L4–5 is a potential alternative treatment method to correct sagittal malalignment while avoiding possible injury to the L5 nerve roots that can be seen in the reduction of high-grade isthmic spondylolisthesis.

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“…57 Higher mechanical stability and faster symptomatic resolution can be achieved by modifying the Grob technique to involve a trans-discal L5-S1 fixation with L5-S1 pedicle screw instrumentation. 58 To evaluate the efficacy of circumferential fusion, Ferrero et al 59 examined the radiological and functional outcomes of HGS in 20 patients treated by intrasacral fixation, dome resection, and circumferential fusion. At a mean follow-up of 7.2 years, the authors found that lumbosacral angle kyphosis and olisthesis were reduced (658 6 14 versus 998 6 11, P , .001 and 81% 6 19 versus 45% 6 18, P , .001, respectively).…”

Section: Circumferential Interbody Fusionmentioning

confidence: 99%

High-Grade Spondylolisthesis in Adults: Current Concepts in Evaluation and Management

et al. 2020

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Background: Information regarding the treatment of high-grade spondylolisthesis (HGS) in adults has been previously described; however, previous descriptions of the evaluation and surgical management of HGS do not represent more recent and now established approaches. The purpose of the current review is to discuss current concepts in the evaluation and management of patients with HGS. Methods: Literature review. Results: HGS is diagnosed in up to 11.3% of adults with spondylolisthesis and typically presents as nonspecific lower back pain. Regarding evaluation, a thorough history and physical examination should be performed, which may help predict the presence of HGS. Diagnostic imaging, and specifically the use of spino-pelvic parameters, are now commonly implicated in guiding treatment course and prognosis. When surgical intervention is indicated, surgical approaches include in situ fusion variations, reduction and partial reduction with fusion, and vertebrectomy. Although the majority of studies suggest improvements with these approaches, the literature is limited by a low level of evidence with regards to the superiority of one technique when compared with others. Conclusions: HGS is a unique cause of low back pain in adults that carries considerable morbidity, but rarely presents with neurologic symptoms. Although the definitions, classifications, and methods of diagnosis of this spinal deformity have been established and accepted, the ideal surgical management of this deformity remains highly debated. Fusion in situ techniques are often technically easier to perform and provide lower risk of neurologic complications, whereas reduction and fusion techniques offer greater restoration of global spino-pelvic balance. Preoperative spinopelvic parameters may have utility in assisting in procedural selection; however, future, higher-quality and longer-term studies are warranted to determine the optimal surgical intervention among the widely available techniques currently used, and to better define the indications for these interventions.

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Radiological and functional outcomes of high-grade spondylolisthesis treated by intrasacral fixation, dome resection and circumferential fusion: a retrospective series of 20 consecutive cases with a minimum of 2 years follow-up

Cited by 12 publications

References 29 publications

The Lamartina Square and Severity Index in Surgery for High-Grade Lumbar Listhesis

The Lamartina Square and Severity Index in Surgery for High-Grade Lumbar Listhesis

Restoration of sagittal alignment in high-grade isthmic spondylolisthesis using the reverse Bohlman technique with anterior lumbar interbody fusion using a hyperlordotic cage at L4–5: illustrative case

High-Grade Spondylolisthesis in Adults: Current Concepts in Evaluation and Management

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