A Comparative Study between Pedicle Screw Instrumentation with Posterolateral Fusion and Pedicle Screw Instrumentation with Interbody Fusion in Patients of Lumbar Spondylolisthesis

ABSTRACT

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.