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Pediatric Lumbosacral Spondylolisthesis: Overcoming the Disability!
Anant Mehrotra1, Satya D Pandey2, Suyash Singh3
1Department of Neurosurgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
Congenital spondylolisthesis, often high-grade, presents a surgical challenge. Posterior decompression effectively relieved pain and improved function in pediatric patients, with in situ fixation being a viable option in select cases.
Area of Science:
- Spine Surgery
- Pediatric Orthopedics
- Radiology
Background:
- Congenital spondylolisthesis involves facet joint dysplasia or pars defects.
- This condition requires careful clinical and radiological evaluation.
Purpose of the Study:
- To analyze the clinical and radiological features of pediatric congenital lumbar and lumbosacral spondylolisthesis.
- To evaluate treatment options and outcomes in affected children.
Main Methods:
- Retrospective analysis of 22 pediatric patients diagnosed with congenital lumbar/lumbosacral spondylolisthesis (2018-2021).
- Follow-up assessment of clinical and radiological outcomes.
Main Results:
- High-grade listhesis (grades 3-5) was prevalent (72.7%), predominantly at L5-S1 (91%).
- All patients experienced neurogenic claudication and radiculopathy, with significant improvement in pain and Oswestry Disability Index (ODI) scores postoperatively.
- Surgical management included multi-level fixation, with Minimally Invasive Transforaminal Lumbar Interbody Fusion (MIS TLIF) in two cases.
Conclusions:
- Congenital lumbar spondylolisthesis typically presents as high-grade slippage.
- Posterior decompression offers effective pain relief, while in situ fixation can be successful in specific cases.
- Surgical management requires careful consideration of intraoperative neuromonitoring parameters.
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