Reduction of high-grade spondylolisthesis using Edwards instrumentation

Area of Science:

• Orthopedic Surgery
• Spinal Surgery
• Surgical Techniques

Background:

• High-grade spondylolisthesis often involves significant sagittal imbalance, pain, and neurological deficits.
• Patients typically present with severe slip (average 89%) and slip angles (average 50 degrees).
• Surgical intervention is indicated for intractable pain, progressive slippage, and inability to maintain an upright posture.

Purpose of the Study:

• To evaluate the efficacy of posterior decompression and reduction with the Edwards Modular Spine System for high-grade spondylolisthesis.
• To assess the technique's effectiveness in correcting sagittal imbalance and alleviating symptoms.
• To determine the functional and radiographic outcomes of this specific surgical approach.

Main Methods:

• Retrospective review of sixteen patients with Grade III or higher spondylolisthesis.
• Surgical intervention involved posterior decompression and reduction using the Edwards Modular Spine System.
• Clinical and radiographic data, including percent slip and slip angle, were analyzed pre- and postoperatively.

Main Results:

• Significant reduction in average slip from 89% to 29% and slip angle from 50 to 24 degrees.
• Ten patients achieved excellent results, and five had good results; one patient had a fair outcome.
• Complications included temporary neurologic impairment in three patients and hardware failure in four, requiring revision.

Conclusions:

• Posterior decompression and reduction with the Edwards Modular Spine System is a technically demanding procedure for high-grade spondylolisthesis.
• The technique can effectively reduce severe deformity and yield good to excellent outcomes in select patients.
• Enhancing sacral fixation may be crucial in minimizing hardware-related complications and improving long-term success.