J Korean Soc Spine Surg.  2006 Sep;13(3):177-183. 10.4184/jkss.2006.13.3.177.

Factors affecting Reduction of Slippage in Posterolateral Fusion for Spondylolytic Spondylolisthesis

• Cho KJ
• Moon KH
• Lee DJ
• Lee KY
• Kim KH
• Park SR

• KMID: 2209639
• DOI: http://doi.org/10.4184/jkss.2006.13.3.177

Abstract

STUDY DESIGN: A retrospective study.
OBJECTIVES
The purpose of this study was to analyze the reduction of spondylolisthesis after postural reduction and pedicle screw instrumentation for low-grade spondylolytic spondylolisthesis, and to determine the factors affecting reduction.
MATERIALS AND METHODS
Twenty patients (mean age 52.5 years old; range, 30-71 years old), who underwent pedicle screw instrumentation and posterolateral fusion after wide laminectomy and facetectomy, were reviewed. The minimum follow-up period was 2 years. The percentage of slippage was measured on lateral radiographs by the Taillard method. We measured the slip angle, sacral inclination, lumbar lordosis, disc height, and angulation and translation on flexion-extension stress views. These radiological parameters were analyzed statistically for correlation with the reduction of slippage.
RESULTS
In these passive reduction surgeries, no forceful reduction was attempted. The average percentage of slippage was 20.6% preoperatively, 13.0% after instrumentation, and 19.5% at the last visit. The reduction of slippage had a correlation with hypermobile angulation on flexion-extension radiographs (p=0.02). There were no significant correlations between the amount of reduction and translation on flexion-extension radiographs (P=0.99), slip angle (P=0.79), disc space height (P=0.6), lumbar lordosis (P=0.68), and sacral inclination (P=0.35).
CONCLUSION
Loss of reduction that was achieved by postural reduction with pedicle screw instrumentation for spondylolytic spondylolisthesis occurred at the final follow-up. There was a negative correlation between the reduction of slippage and hypermobile angulation on flexion-extension dynamic radiographs.

Keyword

Spondylolisthesis; Posterolateral fusion; Reduction; Factors affecting reduction

MeSH Terms

Animals
Follow-Up Studies
Humans
Laminectomy
Lordosis
Retrospective Studies
Spondylolisthesis*

Figure

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  Fig. 1. (A) Preoperative lateral radiograph of a 49 year old patient with spondylolytic spondylolisthesis shows 25% of slippage. (B, C) The flexion-extension dynamic lateral radiograph shows 15o change of angulation.

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  Fig. 2. (A) After pedicle screw instrumentation and posterolateral fusion, the slippage reduces. (B) However, loss of reduction devel-ops. The slippage is worse on the xray at the last visit than preoperative x-ray.

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