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Related Experiment Videos

Lumbar spinal instability (olisthesis) after extensive posterior spinal decompression.

C K Lee

    Spine
    |May 1, 1983
    PubMed
    Summary

    Extensive spinal decompression alone may be sufficient, as spinal fusion did not prevent olisthesis and had a high pseudarthrosis rate. Fusion should be exceptional, not routine, for these procedures.

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    Area of Science:

    • Spine Surgery
    • Orthopedics
    • Neurosurgery

    Background:

    • Extensive posterior spinal decompression is performed for various spinal conditions.
    • The role of concomitant spinal fusion in preventing postdecompression olisthesis is debated.
    • Factors contributing to postdecompression olisthesis require further investigation.

    Purpose of the Study:

    • To investigate the incidence, clinical significance, and contributing factors of postdecompression olisthesis.
    • To evaluate the indication for spinal fusion during extensive decompression.
    • To assess the effectiveness of spinal fusion in preventing olisthesis and pseudarthrosis.

    Main Methods:

    • Retrospective review of 27 patients undergoing extensive posterior spinal decompression.

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  • Analysis of patient demographics, surgical procedures (decompression with or without fusion), and follow-up data.
  • Assessment of newly developed postdecompression olisthesis and pseudarthrosis rates.

    • Main Results:

    • The incidence of newly developed postdecompression olisthesis was 3.7%.
    • All patients with preoperative spondylolisthesis showed progression postoperatively.
    • A high incidence of pseudarthrosis (27.3%) was observed after decompression and fusion.
    • Definitive contributing factors for olisthesis were not identified.

    Conclusions:

    • Concomitant spinal fusion is not routinely indicated for patients undergoing extensive posterior spinal decompression.
    • Spinal fusion does not appear to be effective in preventing postdecompression olisthesis.
    • Spinal fusion should be considered an exceptional, rather than routine, procedure in this context.