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Related Experiment Videos

Reduction-fixation spinal system in spondylolisthesis

C C Niu1, W J Chen, L H Chen

  • 1Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan, Republic of China.

American Journal of Orthopedics (Belle Mead, N.J.)
|June 1, 1996
PubMed
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Short segmental fixation using a reduction-fixation system effectively treats spinal instability and spondylolisthesis, yielding high fusion rates and symptom relief. However, potential complications like screw loosening and adjacent instability require careful consideration.

Area of Science:

  • Orthopedic Surgery
  • Spinal Surgery
  • Biomedical Engineering

Background:

  • Posterior transpedicular instrumentation with short segmental fixation is a growing surgical approach for spinal instability.
  • Spondylolisthesis, a common spinal disorder, often necessitates surgical intervention for effective management.

Purpose of the Study:

  • To evaluate the efficacy and outcomes of a specific reduction-fixation spinal system for treating unstable spinal problems, particularly spondylolisthesis.
  • To assess the system's ability to achieve rigid fixation, reduce deformities, and promote solid spinal fusion.

Main Methods:

  • A cohort of 85 patients with spinal instability underwent posterior transpedicular instrumentation using a reduction-fixation system.
  • The system incorporated variable-angle pedicle screws (5.75- to 6.25-mm diameter) and an 8-mm diameter rod for short-segment fixation.

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  • Clinical outcomes (back pain, sciatica, claudication) and radiographic fusion rates were assessed postoperatively.

    • Main Results:

    • The system achieved significant reduction in spondylolisthetic slipping width (71% +/- 5.3%).
    • Good-to-excellent clinical results were reported for 84% of patients with back pain, 88% with sciatica, and 86% with claudication.
    • Radiographic studies showed a 91% rate of solid posterolateral fusion.
    • Complications included pedicle screw loosening (12%), breakage (7%), adjacent instability (7%), and nerve root injury (2%).

    Conclusions:

    • The reduction-fixation spinal system provides rigid short-segment fixation and effective reduction of spondylolisthetic deformities.
    • Posterior lumbar interbody fusion is crucial for achieving lasting reduction and stability.
    • While effective, the system is associated with specific complications that necessitate careful surgical planning and patient selection.