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Severe spondylolisthesis. Reduction and internal fixation.

W T Dick1, B Schnebel

  • 1Department of Orthopaedics, Children's Hospital University of Basel, Switzerland.

Clinical Orthopaedics and Related Research
|July 1, 1988
PubMed
Summary
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This study presents a surgical algorithm for spondylolysis and spondylolisthesis, achieving significant correction in anterior displacement and spinal curvature. The technique improved patient pain and function, though neurological complications and hardware issues warrant further investigation.

Area of Science:

  • Spine surgery
  • Orthopedic surgery
  • Biomechanical engineering

Background:

  • Spondylolysis and spondylolisthesis often require surgical intervention for significant anterior displacement and spinal deformity.
  • Traditional surgical approaches may have limitations in achieving optimal correction and stability.

Observation:

  • A cohort of 15 patients (average age 20) with >50% anterior displacement underwent a novel surgical technique.
  • The procedure involved anterior release and fusion combined with posterior reduction and internal fixation.
  • Mean follow-up was 24 months.

Findings:

  • The surgical algorithm achieved an average 46% correction of anterior displacement.
  • Kyphosis at L5-S1 was corrected by a mean of 20 degrees, and lumbar lordosis improved by 12 degrees.

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  • All patients reported improved postoperative pain and function, with L4 segment preservation in 13 cases.

    • Implications:

    • This combined anterior-posterior approach demonstrates efficacy in correcting severe spondylolisthesis and improving clinical outcomes.
    • Potential complications include neurological deficits and hardware failure, necessitating careful patient selection and monitoring.
    • Further long-term evaluation is recommended to fully assess the durability and safety of this surgical management algorithm.