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Traumatic Lumbar Spondylolisthesis: A Systematic Review and Case Series
Mikhail Lew P Ver1, John R Dimar1, Leah Y Carreon1
1Norton Leatherman Spine Center, Louisville, KY, USA.
Global Spine Journal
|September 26, 2019
Summary
Traumatic spondylolisthesis requires operative management including reduction, decompression, and fusion. Interbody fusion offers superior outcomes, particularly for injuries involving disc lesions.
Area of Science:
- Orthopedics
- Neurosurgery
- Spine Surgery
Background:
- Traumatic spondylolisthesis, a rare injury from high-energy trauma, involves posterior element damage and listhesis.
- Literature primarily consists of case reports and series, lacking evidence-based treatment guidelines.
Purpose of the Study:
- To propose evidence-based treatment recommendations for traumatic spondylolisthesis.
- To introduce a novel classification system for this rare spinal injury.
Main Methods:
- A systematic review of literature from PubMed, EMBASE, and Cochrane databases.
- Inclusion of 77 articles (Level IV and V evidence) and 9 cases from a case series analysis, totaling 125 reviewed cases.
Main Results:
- Operative treatment was performed in 93.6% of cases, with interbody fusion (IB) showing significantly higher fusion rates (87%) compared to posterior spinal fusion (PSF) (46%) in cases with disc injuries.
- Significant improvement in pain and neurological symptoms was observed post-operatively.
- Overall fusion rate was 74% with a 22% complication rate.
Conclusions:
- Recommended treatment for traumatic spondylolisthesis includes operative management: reduction, decompression, instrumentation, and fusion.
- Interbody fusion is advised for improved fusion outcomes, especially when preoperative disc lesions are present.
