Uninstrumented posterolateral spinal arthrodesis: is it the gold standard technique for I degrees and II degrees grade spondylolisthesis in adolescence?

Eur Spine J. 2009 Jun;18 Suppl 1(Suppl 1):126-32. doi: 10.1007/s00586-009-0983-z. Epub 2009 May 5.

Abstract

We retrospectively reviewed the outcome of uninstrumented posterolateral spinal arthrodesis in 49 patients with lumbar isthmic spondylolisthesis grades I degrees and II degrees in adolescent patients in the time of surgery, who participate at follow-up, between 1980 and 1995. The goal of our study is to analyse the clinical and radiographic imaging at long follow-up in uninstrumented posterolateral arthrodesis and to evaluate the efficiency and the validity of surgical technique in young patients (<18 years). All patients had failed previous conservative treatment. The average age at follow-up was 33.5 years (range 25-42 years) and the average follow-up time was 19.7 years (range 12-27 years). The clinical outcome measures were the Oswestry Disability Index, the SF-36, and the visual analogic score. All measures assessed the endpoint outcomes at 20 years after surgery. The outcome of spinal fusion was good with 43 (87.7%) patients attaining solid fusion, pseudoarthrosis in 6 patients (12.3%). None of our patients complained of excessive postoperative wound pain. Additionally, no complications, such as wound infection, were encountered. Satisfactory results were obtained in 94% of patients and this was closely associated with the rate of successful fusion. The results suggest that clinical outcome is closely related to the attainment of solid fusion.

MeSH terms

  • Adult
  • Age Factors
  • Aging / physiology
  • Disability Evaluation
  • Disease Progression
  • Female
  • Humans
  • Lumbar Vertebrae / growth & development
  • Lumbar Vertebrae / pathology*
  • Lumbar Vertebrae / surgery*
  • Male
  • Middle Aged
  • Outcome Assessment, Health Care
  • Pain, Postoperative / epidemiology
  • Postoperative Complications / diagnostic imaging
  • Postoperative Complications / epidemiology
  • Postoperative Complications / pathology
  • Pseudarthrosis / diagnostic imaging
  • Pseudarthrosis / epidemiology
  • Pseudarthrosis / pathology
  • Radiography
  • Retrospective Studies
  • Severity of Illness Index
  • Spinal Fusion / methods*
  • Spinal Fusion / standards*
  • Spinal Fusion / statistics & numerical data
  • Spondylolisthesis / diagnostic imaging
  • Spondylolisthesis / pathology*
  • Spondylolisthesis / surgery*
  • Surgical Wound Infection / epidemiology
  • Treatment Outcome