Sacrospinalis muscle pedicle bone graft in posterolateral fusion for spondylolisthesis

ABSTRACT

This prospective study was conducted to evaluate the results of sacrospinalis muscle pedicle bone graft as a method to improve the quality of fusion mass after posterolateral fusion for lumbar sporidylolisthesis. This study included twenty patients with lumbar spondylolisthesis [7 Grade I. 10 Grade II and 3 Grade III]. All patients had low back pain and associated radicular pain was present in 12. All patients failed to respond to adequate conservative treatment. There were 13 females and 7 males. The patients were aged between 25 and 55 years with an average of 37.5 years. Posterolateral spinal fusion with sacrospinalis muscle pedicle bone graft on the left side and autogenous iliac bone chips on the right side with the use of transpedicular internal fixation system, was done in all patients. In 12 patients with radicular pain, laminectomy and discectomy was done in addition. The period of follow up ranged from 8 months to 18 months. Satisfactory osseus fusion was obtained in [85%] of patients on the left side where muscle pedicle bone graft was used while satisfactory osseus fusion was obtained in [70%] of patients on the right side where iliac bone chips were used. Functional improvement was obtained in 90% of patients with excellent to good result. No scoliosis or weakness of the extensor muscles of the back developed after reanchorage of the sacrospinalis muscle to the lumbosacral spines. We recommend the use of sacrospinalis muscle pedicle bone graft to improve the quality of fusion mass obtained in posterolateral fusion for treatment of spondylolisthesis