Operative Treatment of Lumbar Spondylolisthesis using Steffee VSP and Cut Pedicle Screw: New Operative Technique

Chae, In Jung; Seo, Seung Woo; Lim, Dang Jae

Abstract

STUDY DESIGN: The authors have investigated the clinical results for the lumbar spondylolisthesis treated operatively using the Steffee VSP and cut pedicle screw for satisfactory reduction with saving of functioning segment.
OBJECTIVES
To demonstrate the effectiveness of short segment fusion using the Steffee VSP and cut pedicle screw. SUMMARY OF LITERATURE REVIEW: Spondylolisthesis has been recognized as one of the leading cause of low back pain. Most are successfully managed with conservative treatment, but operative treatment is indicated if conservative treatment fails. Operative treatments are categorized into decompression, reduction and fusion. Especially, in the methods of fusion, there are some controversies between short segment fusion for saving of functioning segment and extended fusion for more amount of reduction.
MATERIALS AND METHODS
We report 29 cases of lumbar spondylolisthesis which were treated operatively using the Steffee VSP and cut pedicle screw from March 1994 to Feb. 1996. The reduction was done by cork screw pulling back mechanism and the short segment fusion was done. The each case was followed up for 1 year 6 months to 3 years 1 month.
RESULTS
Satisfactory reduction was obtained from preoperative 23.3% slippage to postoperative 3.7% by Taillard method. In the functional results, 90% was above good according to the Gill`s criteria without any serious complications.
CONCLUSIONS
We had satisfactory results after this operation. When compared to operative treatment with S-shaped VSP reported by same authors, this procedure had following advantages ; ease to make and decrease of complication such as laminar sclerosis due to wider contact. It is necessary that long-term follow up about pressure effect of cut pedicle screw on above facet joint and lamina, fusion rate and saving of above functioning segment after implant removal.