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Posterior lateral distraction spondylodesis using the twofold sacral bar.

K Zielke, A V Strempel

    Clinical Orthopaedics and Related Research
    |February 1, 1986
    PubMed
    Summary

    Posterolateral distraction spondylodesis effectively stabilizes the lumbosacral joint, offering relief for low-back pain and neurological deficits, especially in patients with prior surgeries. This surgical technique demonstrates good outcomes and low complication rates.

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    Clinical orthopaedics and related research·1992

    Area of Science:

    • Spine Surgery
    • Orthopedics
    • Neurosurgery

    Background:

    • Lumbosacral joint instability often causes low-back pain and neurological deficits.
    • Many patients undergo multiple previous surgeries for these conditions.
    • Posterolateral distraction spondylodesis is a surgical technique for lumbosacral stabilization.

    Purpose of the Study:

    • To evaluate the efficacy of posterolateral distraction spondylodesis using Zielke's twofold sacral bar.
    • To assess outcomes in patients with and without prior surgical history.
    • To determine the complication rate and impact on pseudarthrosis.

    Main Methods:

    • A cohort of over 500 patients underwent posterolateral distraction spondylodesis between 1978 and 1985.
    • Patients were categorized based on prior surgical interventions.

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  • Outcomes measured included pain relief, neurological deficit resolution, and pseudarthrosis rates.

    • Main Results:

    • Patients without prior surgery reported better outcomes for pain and neurological deficits.
    • 49% of multi-operated patients achieved pain relief, but distraction aided long-term neurological deficits.
    • Neurological complications were low (0.4%), and transpeduncular screw modification reduced pseudarthrosis from 20% to 5.5%.

    Conclusions:

    • Posterolateral distraction spondylodesis is a valuable treatment for lumbosacral joint stabilization.
    • The technique provides relief for persistent neurological deficits.
    • Modifications like transpeduncular screws improve fusion rates and reduce pseudarthrosis.