RESUMO
Background: Many different treatment modalities have been advocated by different authors from time to time for lumbarspondylolisthesis. Many cases, the condition can be treated conservatively. However, when the symptoms persist, surgeryneeds to be performed. The principle of underlying surgery includes stabilization of the slipping vertebrae. Various operativemethods encompassing this principle include stabilization with pedicle screw fixation and fusion which can either posterolateralor interbody fusion, anterior lumbar interbody fusion, posterior lumbar interbody fusion, or transforaminal lumbar interbodyfusion. The objective of this study was to compare the surgical efficacy in terms of stability and fusion achieved using pediclescrew-rod instrumentation with posterolateral fusion and pedicle screw-rod instrumentation with interbody fusion in lumbarspondylolisthesis and to study THE functional and clinical recovery using the Revised Oswestry Disability Index score.Materials and Methods: A prospective study was carried out to compare the clinical and radiological outcomes between Pediclescrew-rod instrumentation with either posterolateral fusion and interbody fusion after adequate decompression in patient oflumbar spondylolisthesis. All patients as per the inclusion criteria were admitted, underwent surgery between March 2010 andMarch 2012, and were included in the study.Results: The total of 50 patients was included in our study. Both male and female patients were equally distributed in both thegroups, wherein postreolateral fusion had 13 female patients and those with interbody fusion had 13 male patients. Our studyshows marked improvement in Revised Oswestry Disability score postoperatively with good-to-excellent results in both thegroups. We achieved good solid radiological fusion earliest on the 3rd month in both the groups with good stability.Conclusion: Our results showed similar clinical and functional outcome in both the groups with no significant statistical differencefound. However, we conclude that in cases where reduction is required and there is instability affecting the three column ofspine interbody fusions with pedicle screws-rod instrumentation provide a more solid mechanical construct.
RESUMO
Background: The prevalence of back pain has been reported between 49% and 80%. Except for cases that require immediatesurgical intervention, the first-line treatment involves medical choices. 90% of attacks of sciatica respond to conservativemanagement. Surgical intervention when indicated involves discectomy and various operative methods include laminectomydiscectomy, microlumbar discectomy, and microendoscopic discectomy. The objective of this study was to evaluate theadvantages and disadvantages and outcome of the above-mentioned surgical operations for lumbar disc herniation (LDH) andthen, specifically, the outcomes for each of them using Odom’s criteria.Materials and Methods: A prospective study was carried out between April 2015 and April 2017 to compare the advantages/disadvantages and outcome of various surgical interventions in LDH, namely laminectomy discectomy (Group A), microlumbardiscectomy (Group B), and microendoscopic discectomy (Group C) with each group consisting of 30 patients. All patients wereadmitted as per inclusion criteria.Results: In each group of our study, the mean age and sex distribution were comparable and statistically not significant. Ourstudy showed the post-operative hospital stay and the need for post-operative analgesia was low for microendoscopic surgery,but on long-term evaluation with Odom’s criteria, laminectomy achieved better outcomes than other methods.Conclusion: Our study showed that microlumbar discectomy and microendoscopic discectomy have a better short-term outcomeas compared to laminectomy discectomy. However, long-term results are comparable.