Anterior Lumbar Interbody Fusion with Pedicle Screw Fixation for Elderly Isthmic Spondylolisthesis

ABSTRACT

OBJECTIVE: The surgical outcome of anterior lumbar interbody fusion(ALIF) with pedicle screw fixation for elderly isthmic spondylolisthesis was analyzed. METHODS: Consecutive nineteen elderly patients (aged 65 years or more) with isthmic spondylolisthesis (Grade I or II) who underwent single level ALIF with pedicle screw fixation in 2002 were analyzed. Using clinical chart and mailed questionnaires, preoperative and postoperative Visual Analogue Scale(VAS) of back and leg pain and postoperative Macnab criteria were evaluated. RESULTS: The mean age at the time of operation was 68.4 years (range 65 to 78 years). Twelve patients underwent ALIF with percutaneous pedicle screw fixation. Seven patients underwent ALIF followed by posterior decompression and pedicle screw fixation. The postoperative complication rate was 10.5% (wound dehiscence in 1 patient and incisional hernia in 1 patient). There was no postoperative major morbidity or mortality. At a mean follow-up duration of 30.7 months (range 25 to 35 months), 93.3% (14/15) of the patients showed excellent or good outcomes in terms of Macnab criteria. The mean VAS scores of back pain and leg pain significantly decreased after surgery. CONCLUSION: ALIF with pedicle screw fixation yielded favorable results for elderly isthmic spondylolisthesis in selected cases.