Long-term Result of Circumferential Stabilization for Spondylolytic Spondylolisthesis by One Stage Posterior Approach

ABSTRACT

OBJECTIVE: The purpose of this study is to evaluate the efficacy of circumferential fusion with PLIF(posterior lumbar interbody fusion) using fusion cages and pedicle screw fixation by one stage posterior approach in the patients with spondylolytic spondylolisthesis. METHODS: Total 254 patients with spondylolytic spondylolisthesis underwent circumferential fusion during last 10 years. Among them, 117 patients could be followed for more than two years (mean follow up period: 27.4+/-5.5 months). The clinical and radiographic data were reviewed retrospectively. RESULTS: The clinical success rate according to Prolo's scale was achieved in 86.3% of patients and the solid bony fusion was occurred in 92.3%. The anterior slipping was reduced from 9.54+/-3.89mm to 3.26+/-2.46mm(p<0.001, paired t-test). Angular instability in lateral dynamic X-ray was improved in all case immediately after surgery. There were 3 cases of instrument-related complication (2.6%) such as loosening, disconnection, and cage retropulsion. CONCLUSION: The circumferential stabilization with PLIF using fusion cages and pedicle screw fixation by one stage posterior approach has been found to be an effective and safe procedure, demonstrating a high fusion rate and clinical success with a rare complications.