Residual gait abnormalities in surgically treated spondylolisthesis

Area of Science:

• Orthopedics
• Spine Surgery
• Pediatric Orthopedics

Background:

• High-grade spondylolisthesis (grades IV, V) in adolescents often requires surgical intervention when conservative treatments fail.
• In situ fusion is a surgical technique used to stabilize the spine.
• Assessing long-term functional outcomes, including gait, is crucial after spinal fusion.

Purpose of the Study:

• To evaluate for the presence of crouch gait or other gait abnormalities in adolescents who underwent in situ fusion for high-grade spondylolisthesis.
• To correlate clinical success parameters with objective gait analysis findings.

Main Methods:

• Retrospective study of seven adolescent patients with high-grade spondylolisthesis treated with in situ fusion.
• Comprehensive assessment including gait analysis, radiographic analysis, and physical examination.
• Detailed observation of trunk and hip motion during gait.

Main Results:

• All seven patients achieved solid bony union, pain relief, and resolution of hamstring spasm.
• Four patients exhibited slight forward trunk lean with increased hip flexion during gait.
• One patient showed increased trunk extension with limited hip flexion; two patients had normal gait.
• No significant residual crouch gait was quantifiable in patients with solid fusion.

Conclusions:

• In situ fusion for high-grade spondylolisthesis in adolescents can lead to successful bony union and symptom resolution.
• Subtle gait abnormalities, such as trunk lean or extension, may be present post-fusion.
• Further research is needed to fully understand and quantify long-term functional adaptations after this procedure.