Document Detail


Treatment of severe spondylolisthesis by reduction and pedicular fixation. A 4-6-year follow-up study.
MedLine Citation:
PMID:  8235846     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Ten consecutive patients with severe spondylolisthesis were treated with reduction and pedicular fixation (four Internal Fixator instrumentations, six Cotrel-Dubousset instrumentations). There were six Grade III spondylolisthesis and four spondyloptoses at the L5/S1 level. All patients had complete clinical and radiographic evaluation with an average follow-up of 56 months (range, 43-75 months). The percentage of slippage averaged 78.5% preoperatively and 39.6% postoperatively. The slip angle averaged 43 degrees preoperatively and 17 degrees postoperatively. Four patients with spondyloptosis were treated with combined posterolateral and interbody fusion and had solid fusion without loss of reduction. Five of six patients in whom reduction and stabilization was performed by a single posterolateral fusion demonstrated loss of reduction, nonunion, and implant failure. Four of these patients were reoperated. Ultimately all patients had resolution of pain, solid fusion, and no further slip progression. Reduction, pedicular fixation, and combined posterolateral and interbody fusion is a technically demanding procedure, which should be reserved for selected patients. Pedicular fixation systems may only allow permanent reduction and stabilization of high-grade spondylolisthesis in conjunction with a combined interbody and posterolateral fusion.
Authors:
N Boos; D Marchesi; K Zuber; M Aebi
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Spine     Volume:  18     ISSN:  0362-2436     ISO Abbreviation:  Spine     Publication Date:  1993 Sep 
Date Detail:
Created Date:  1993-12-22     Completed Date:  1993-12-22     Revised Date:  2009-07-09    
Medline Journal Info:
Nlm Unique ID:  7610646     Medline TA:  Spine (Phila Pa 1976)     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1655-61     Citation Subset:  IM    
Affiliation:
Department of Orthopaedic Surgery, Inselspital University of Berne, Switzerland.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Child
Female
Follow-Up Studies
Humans
Lumbosacral Region
Male
Middle Aged
Orthopedic Fixation Devices*
Postoperative Period
Spine / radiography
Spondylolisthesis / radiography,  surgery*
Time Factors
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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