| Posterolateral fusion for isthmic spondylolisthesis in adults: analysis of fusion rate and clinical results. | |
| | |
MedLine Citation:
|
PMID: 9884288 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
This is a retrospective study of 83 consecutive adult patients with isthmic spondylolisthesis who underwent identical decompressive surgery combined with posterolateral spine fusion. We sought to determine factors that affect the fusion rate and clinical outcomes for adult patients with isthmic spondylolisthesis. The outcome of operative treatment for isthmic spondylolisthesis in adults has been poorly documented, as opposed to the treatment of children and adolescents. From 1989 to 1994, 83 consecutive adult patients (age 19-66 years; average, 38 years) underwent surgical treatment consisting of the Gill procedure and posterolateral fusion for isthmic lumbosacral spondylolisthesis. Seventy-three patients (46 men and 27 women) were available for an average of 3.8 years' follow-up (1.0-7.4 years). Thirty-eight underwent one-level fusion, and 35 underwent two-level fusions. Pedicle screw instrumentation was performed in 69 patients. A postoperative questionnaire including the Roland index, clinical charts, and radiographs were reviewed by an independent observer to assess the postoperative course, clinical results, and fusion status. Twenty-five variables were evaluated to determine which affected the fusion and success rates. Primary radiologic fusion and clinical success rates were 78 and 71%, respectively. There was a strong positive correlation between radiologic fusion and clinical success. Overall, single-level fusions showed an 82% fusion rate, and two-level fusions, a 74% rate. For two-level fusions, a significantly higher fusion rate was achieved with a rigid pedicle screw-fixation system than a semirigid system (79 vs. 57%). For smokers, cessation from smoking postoperatively did not increase the fusion rate, and patients who continued to smoke after surgery showed a significantly higher rate of pseudarthrosis. Worker's compensation status did not affect clinical results significantly. Patients who continued to take nonsteroidal antiinflammatory drugs (NSAIDs) >3 months postoperatively showed significantly lower fusion and success rates (44 and 37%). Single-level lumbar fusion for isthmic spondylolisthesis was equally effective with either rigid or semirigid pedicle screw instrumentation. For multilevel spine fusion in isthmic spondylolisthesis, rigid pedicle screw-fixation systems resulted in a high fusion rate. A smoking history or NSAIDs use postoperatively had strong negative influences on the fusion and clinical success rates. |
| | |
Authors:
|
M Deguchi; A J Rapoff; T A Zdeblick |
Related Documents
:
|
11805638 - Upper extremity functional assessment after anterior spinal fusion via thoracotomy for ... 10404578 - A double-blind study of capacitively coupled electrical stimulation as an adjunct to lu... 14668498 - Harrington and cotrel-dubousset instrumentation in adolescent idiopathic scoliosis. lon... 15371708 - Prospective pulmonary function comparison of open versus endoscopic anterior fusion com... 3238328 - Pharmacologically induced erection in patients with multiple sclerosis. 11721478 - Clinical analysis of 1539 cases undergoing coronary artery bypass grafting. |
Publication Detail:
|
Type: Journal Article |
Journal Detail:
|
Title: Journal of spinal disorders Volume: 11 ISSN: 0895-0385 ISO Abbreviation: J Spinal Disord Publication Date: 1998 Dec |
Date Detail:
|
Created Date: 1999-05-04 Completed Date: 1999-05-04 Revised Date: 2004-11-17 |
Medline Journal Info:
|
Nlm Unique ID: 8904842 Medline TA: J Spinal Disord Country: UNITED STATES |
Other Details:
|
Languages: eng Pagination: 459-64 Citation Subset: IM |
Affiliation:
|
Division of Orthopedic Surgery, University of Wisconsin, Madison, USA. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adult Aged Anti-Inflammatory Agents, Non-Steroidal / adverse effects Female Humans Lumbosacral Region / surgery Male Middle Aged Retrospective Studies Smoking / adverse effects Smoking Cessation Spinal Fusion / methods* Spondylolisthesis / radiography, rehabilitation*, surgery* Therapeutics |
| Chemical | |
Reg. No./Substance:
|
0/Anti-Inflammatory Agents, Non-Steroidal |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Costimulation pathways in host immune responses to allogeneic hepatocytes.
Next Document: A multi-center prospective study of the CD Spinal System in patients with degenerative disc disease.