Posterolateral fusion for spondylolisthesis in adolescence

Area of Science:

• Orthopedic Surgery
• Spinal Fusion Techniques
• Adolescent Spine Deformities

Background:

• Persistent postoperative slippage is a known complication of posterolateral fusion for adolescent spondylolisthesis.
• Adolescent spondylolisthesis at L5-S1 often presents with significant vertebral displacement.

Purpose of the Study:

• To evaluate the efficacy of posterolateral fusion in treating adolescent spondylolisthesis at L5-S1.
• To assess the incidence of persistent slippage and outcomes following surgical intervention.
• To introduce a novel method for documenting L5-S1 position.

Main Methods:

• Retrospective analysis of 40 adolescent patients undergoing posterolateral fusion for L5-S1 spondylolisthesis.
• Classification of preoperative slip severity (Grade 3 or worse in 23 patients).
• Postoperative monitoring for slippage progression and assessment of bone graft incorporation, neurologic deficits, and pain.

Main Results:

• Complete bone graft incorporation was observed in all patients.
• Resolution of neurologic deficits and pain was achieved in all cases.
• Two patients experienced postoperative slip progression, which spontaneously resolved.

Conclusions:

• Posterolateral fusion is an effective treatment for adolescent spondylolisthesis at L5-S1, leading to successful healing and symptom resolution.
• Surgical technique advancements and postoperative casting contribute to improved outcomes.
• The displacement index provides a valuable tool for quantifying L5-S1 vertebral alignment.