Unstable stenotic degenerative lumbar spondylolisthesis

ABSTRACT

Unstable stenotic degenerative lumbar spondylolisthesis is a special clinical entity that merits special diagnostic efforts to identify pre-stenotic levels as well as the pathological changes responsible for stenotic symptoms. Following a meticulous diagnostic, extensive decompression, bilateral posterior pedicular instrumentation and unilateral, intertransverse fusion resulted in 78.3% favorable clinical outcome and 95.4% solied fusion rate after a 31 months period of follow up in 22 patients. Individual clinical symptoms showed variable improvement rates. Low back pain improved in 84.2%, claudication distance below 500 meters improved in 76.4%, sciatic pain improved in 86.6% and there was 66.6% neurological recovery. Fusion rate was 95.4% [21 patients]. The results of this study have confirmed that the extent of decompression is the most single parameter associated with early favorable clinical outcome. Also, instrumentation is usually associated with a higher rate of fusion and a lower rate of recurrence, but not related to early clinical outcome: