A Prospective Study on the Functional Outcomes of Surgical Management of Lumbar and Lumbosacral Spondylolisthesis...

Introduction Low back pain is one of the most commonly reported health concerns worldwide. Its etiologies include mechanical injuries, overuse, and nerve compression resulting from various spinal disorders such as spondylolisthesis, disc herniation, spinal canal stenosis, and degenerative disc disease. Among these, spondylolisthesis - the anterior displacement of one vertebra over another - frequently contributes to spinal instability. The term is derived from the Greek words spondylos (vertebra) and olisthesis (slip). Spondylolisthesis may arise due to ligamentous laxity, pars interarticularis defects, trauma, or post-surgical procedures. In symptomatic cases, pedicle screw fixation combined with posterolateral fusion (PLF) is a well-established surgical technique aimed at stabilizing the affected spinal segments, achieving vertebral fusion, and preventing further slippage progression. Methodology It is a prospective observational study. The patients who met the inclusion and exclusion criteria were admitted to the Department of Orthopedics, Bijapur Liberal District Education Association (BLDE; Deemed to be University), Shri B. M. Patil Medical College, Hospital and Research Centre, Vijayapura, Karnataka, India. The patients were informed about the study in all respects, and written informed consent was obtained. The study was carried out between May 1, 2023, and December 1, 2024, with a follow-up period of six months postoperatively. Data were collected on patient demographics, symptom duration, radiographic findings, surgical parameters, and clinical outcomes. Results A total of 36 patients were evaluated postoperatively (16 males and 20 females). The radiological fusion rate at six months was 72.2%. The average operative time (from incision to wound closure) was 3.5 hours, and the mean intraoperative blood loss was 248 mL. Statistically significant improvements were observed in visual analog scale (VAS) scores and modified Oswestry Disability Index (ODI) at the six-month follow-up. The VAS score improvement showed a P-value < 0.00001, confirming its high level of significance. Functional outcomes, as measured by the modified ODI and analyzed using the Wilcoxon signed-rank test, also demonstrated substantial improvement in patient-reported quality of life. Conclusions Our study concludes that pedicle screw-rod instrumentation combined with PLF is a safe, effective, and reliable surgical option for the treatment of low-grade spondylolisthesis. The technique demonstrated minimal postoperative complications and provided substantial improvements in both pain relief and functional outcomes. The favorable results were observed in patients with preoperative neurological deficits, lower degrees of vertebral slip, and multi-level fusion. Given these findings, we advocate for the use of pedicle screw-rod systems with PLF as a preferred modality for managing lumbar and lumbosacral spondylolisthesis.