Failed arthrodesis of the spine for severe spondylolisthesis. Salvage by interbody arthrodesis

Four patients who had had grade-III or grade-IV symptomatic spondylolisthesis and a failed posterior or posterolateral arthrodesis were treated with transperitoneal anterior lumbosacral interbody arthrodesis and fixation with a fibular graft; the procedure was sometimes followed by posterolateral arthrodesis of the spine. The patients were examined ten to twenty-two years after the salvage operation. At follow-up, all had a solid fusion of the fifth lumbar to the first sacral vertebra. No neurological deficits had worsened and no iatrogenic neurological deficits had developed. The slip angle had improved by an average of 23.2 degrees (range, 12 to 35 degrees).