J Korean Soc Spine Surg.  2003 Jun;10(2):104-112. 10.4184/jkss.2003.10.2.104.

Comparison between Posterior Lumbar Interbody Fusion with Pedicle Screw Fixation and Posterolateral Fusion with Pedicle Screw Fixation in Spondylolytic Spondylolisthesis in Adults

• Jeon TS
• Moon SH
• Kim NH
• Park KB
• Lee HM

• KMID: 2003207
• DOI: http://doi.org/10.4184/jkss.2003.10.2.104

Abstract

STUDY DESIGN: This was a retrospective study that analyzed and compared the results between a posterior lumbar interbody fusion, and a posterolateral fusion (PLIF+PLF), and PLF alone, in the treatment of spondyolytic spondylolisthesis in adults.
OBJECTIVES
To evaluate the outcomes of two surgical treatment methods for spondylolytic spondylolisthesis-posterolateral fusion alone, and circumferential fusion, using posterior lumbar interbody fusion and posterolateral fusion. SUMMARY OF LITERATURE REVIEW: There have been many reports regarding the surgical treatment of spondylolisthesis. Posterior lumbar interbody fusions have certain distinct mechanical advantages over posterolateral ones. However, the clinical and radiological results do not usually correlate.
MATERIALS AND METHODS
Between January 1998 and December 2001, 38 patients, with spondylolytic spondylolisthesis, were operated on by a single surgeon. Nineteen patients underwent a posterolateral fusion alone (group I), with the same number undergoing an additional posterior lumbar interbody fusion (group II). These two groups were evaluated for their clinical outcomes, radiological measurements and fusion rates.
RESULTS
The losses in the slip reduction were 7.1 and 1.3% in the PLF and PLF+PLIF groups, respectively (P<0.05). The losses in the Meschan angle were 3.3 and 0.2 in the PLF and PLF+PLIF groups, respectively (P<0.05). The losses in the disc height restoration were 10.4 and 3.8% in the PLF and PLF+PLIF groups, respectively (P<0.05). A nonunion was observed in 3 of the PLF cases (15.8%) and 1 of the PLF+PLIF (5.3%). However, the satisfactory clinical results were 84.2 and 73.7% in the PLF and PLF+PLIF groups, respectively (P>0.05).
CONCLUSIONS
Although the addition of a posterior lumbar interbody fusion, to an instrumented posterolateral fusion, following decompression, is more predictable in maintaining a correction and achieving union, a posterolateral fusion may have a better clinical outcome in patients with low grade spondylolytic spondylolisthesis. Therefore, careful patient selection is necessary for each operation.

Keyword

Spondylolytic spondylolisthesis; Posterior lumbar interbody fusion; Posterolateral fusion; Pedicle screw fixation

MeSH Terms

Adult*
Decompression
Humans
Patient Selection
Retrospective Studies
Spondylolisthesis*

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