More than 5 year-Follow-Up After Pedicle Screw Fixation and Fusion for Isthmic Spondylolisthesis / 대한척추외과학회지

ABSTRACT

STUDY DESIGN: A retrospective study. OBJECTIVES: The aim of this study was to analyze the long term follow-up results of the isthmic spondylolisthesis patients who had been treated with pedicle screw fixation and fusion, and were followed up for more than 5 years. An attempt was made to determine the differences between posterior lumbar interbod fusion(PLIF) and posterolateral fusion (PLF). SUMMARY OF LITERATURE REVIEW The surgical treatment of isthmic spondylolisthesis has developed markedly after the introduction of spine fusion and pedicle screw fixation. However, the long-term prognosis after such treatments has not been investigated sufficiently. MATERIALS AND METHODS: Among 53 patients, 38(72%) patients were examined more than 5 years after surgery. The clinical results were evaluated according to Kim's criteria. Radiologically, the degree of slippage and disc height was measured. The changes in the adjacent segments were also observed. RESULTS: PLIF was performed in 26 patients and PLF was performed in 12 patients. In the PLIF group, the clinical results were 'excellent' in 15 patients, 'good' in 8, 'fair' in 2, and 'poor' in 1. In the PLF group, the results were 'excellent' in 8 patients, 'good' in 2, 'fair' in 1, and 'poor' in 1. According to the fusion method, a satisfactory outcome was obtained in 89% of patients in the PLIF group, and 83% in the PLF group, without any statistically significant differences. Radiological analysis was available in 28 (52.8%) patients. There were no statistically significant differences between the PLIF and PLF groups in terms of the reduction and maintenance of slippage and the disc height. CONCLUSIONS: The clinical result of isthmic spondylolisthesis patients who were treated with pedicle screws and fusion were satisfactory in 87% of patients. The clinical and radiological comparison of the fusion methods showed no significant differences between the PLIF and PLF groups.