Additional Posterior Lumbar Interbody Fusion using Threaded Cage in Spondylolisthesis with Instability

Kim, Eung Ha; Song, In Soo

Abstract

STUDY DESIGN: We studied retrospectively the comparison of the clinical and radiologic results of surgical treatment between additional posterior lumbar interbody fusion group and posterolateral fusion with transpedicular screw fixation alone group for spondylolisthesis with segmental instability.
OBJECTIVES
To evaluate the efficacy of additional PLIF group using threaded cage in surgical treatment of spondylolisthesis with instability. SUMMARY OF LITERATURE REVIEW: The interbody gap produced by operative reduction of spondylolisthesis is potential risk factors for redisplacement, implant failure and pseudarthrosis. There have been many reports regarding surgical treatment of spondy-lolisthesis for preventing postoperative redisplacement or complication. However, there have been controversies, which was most effective procedure for maintenance of surgical correction of spondylolisthesis. MATERIAL AND METHOD: A fourteen patients with spondylolisthesis who underwent PLIF using threaded cage in addition to PLF from August 1998 to June 1999(Group A) were compared to twenty-one patients who underwent PLF alone from January 1993 to May 1995(Group B). We assessed the radiologic results of slip reduction(SR), sagittal angle correction(SAC) and disc height restoration(DHR) on preoperative, postoperative and last follow-up lumbar sagittal view and clinical outcomes according to Kirkaldy-Willis criteria.
RESULTS
The Group A / Group B showed postoperative mean SR 13.2%/9.9%, SAC 3.7 degrees /2.3 degrees and DHR 24.1%/6.3%. At last follow up, the Group A / Group B showed mean SR loss 1.0/7.3%, SAC loss 1.2 degrees /5.4 degrees and DHR loss 1.5%/11% respectively. The clinical results were analyzed as 100%/81%(Group A/B) of excellent to good results.
CONCLUSIONS
Additional posterior lumbar interbody fusion with threaded cage was more effective in reduction & maintenance of reduction and showed better clinical results than posterolateral fusion in spondylolisthesis with instability.