Isthmic spondylolisthesis posterolateral fusion with transpedicular fixation in adults

Twenty adult patients with symptomatic isthmic spondylolisthesis under-went in situ posterolaleral fusion with transpedicular Cotrel-Dubousset instrumentation [CD]. Decompression was done in 14 patients [70%] with sciatica. There were 12 women and 8 men. with a mean age of 38 years [range, 20-52 years]. All patients were recommended for surgery after a failed trial of conservative treatment. The degree of olisthesis was: Grade I in 10, Grade II in 8, and Grade III in 2. All patients had low back pain; with leg pain-bilateral in 10 and unilateral in 4. The single level fusion was done at L5 - Sl in 14, and at L4 - L5 in 6 patients. At a mean follow-up of 20 months [range, 12-36 months], successful fusion was achieved in 90% and 85% had excellent or good clinical result. Successful fusion did influence the clinical outcome in terms of pain relief and increased activity. The results justify the use of instrumented posterolateral fusion for treatment of isthmic spondylolisthesis in adults