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High-grade dysplastic spondylolisthesis: surgical technique and case series
C Faldini1, F Barile1, M Ialuna1
1IRCCS Istituto Ortopedico Rizzoli, 1st Orthopaedics and Traumatology Clinic, University of Bologna, Bologna, Italy.
Musculoskeletal Surgery
|October 1, 2022
Summary
This study shows that a one-stage posterior surgical technique effectively reduces and fuses high-grade spondylolisthesis. The all-posterior approach is safe and achieves good outcomes for spinal deformity correction.
Area of Science:
- Orthopedic Surgery
- Spinal Surgery
- Surgical Techniques
Background:
- High-grade spondylolisthesis presents significant challenges in spinal deformity correction.
- Traditional surgical approaches may involve multiple stages and approaches.
- Evaluating novel, single-stage techniques is crucial for improving patient outcomes.
Purpose of the Study:
- To assess the efficacy and safety of an all-posterior, one-stage surgical technique for reducing and fusing high-grade, high-dysplastic spondylolisthesis.
- To evaluate the radiographic and clinical outcomes of this minimally invasive approach.
Main Methods:
- Retrospective review of patients over 11 years old with high-grade spondylolisthesis treated with a posterior-only reduction and fusion.
- Collection of operative data, including time, blood loss, and complications.
- Pre- and post-operative radiographic measurements of spinal alignment (Meyerding grade, slip angle, lumbar lordosis, sagittal vertical axis, etc.).
Main Results:
- Significant improvement in slip angle (p=0.002) and lumbosacral angle (p=0.01), with a decrease in sagittal vertical axis (p=0.02).
- Average surgical time was 275 minutes, with an average blood loss of 635 mL and a short hospital stay of 3.9 days.
- No surgical site infections, mechanical complications, or pseudoarthrosis were observed, with no revision surgeries required.
Conclusions:
- The one-stage, all-posterior approach for high-grade spondylolisthesis is a safe and effective surgical option.
- This technique demonstrates good radiographic correction and avoids major complications.
- Despite technical demands, it offers a viable solution for complex spinal deformities.
