Abstract:
STUDY DESIGN:This study retrospectively compares the clinical and radiologic outcomes of unilateral transforaminal lumbar interbody fusion (TLIF) with those of transvertebral screw fixation of the lumbosacral spine in high-grade spondylolisthesis. OBJECTIVE:To examine the outcome and perioperative complications of unilateral TLIF and compare those results with Transvertebral Screw Fixation in the treatment of high-grade spondylolisthesis. SUMMARY OF BACKGROUND DATA:High-grade spondylolisthesis has been associated with a high complication and failure rate regardless of the method of treatment. We compare 2 techniques to improve success rates. METHODS:Forty patients were divided into 2 groups: group A, unilateral TLIF, and group B, transacral screws. The mean age was 33 years (range, 19-48 years), and the mean follow-up was 35 months (range, 24-48 months). The mean grade of spondylolisthesis measured by Meyerding grading was 3.6 (range, 3-5). A Scoliosis Research Society outcome score was obtained on all patients. Fusion was determined by both radiograph and computed tomography scan. RESULTS:Group A: 100% fusion. The slip angle improved from 38.6 degrees (range, 24-78 degrees ) before surgery to 23.8 degrees (range, 12-38 degrees ) after surgery. Group B: 95% of patients evidenced solid fusion by the 6-month follow-up. The slip angle, improved from 38.2 degrees (range, 22-78 degrees ) before surgery to 23 degrees (range, 9-36 degrees ) after surgery. There was no significant improvement in the percentage slip or the sacral inclination in any of the groups. COMPLICATIONS:A: 7 unintended durotomies and 3 wound infections. B: 1 unintended durotomy, 1 pseudarthrosis, 2 wound infections, and 1 implant failure. There were no neurologic complications in any of the groups. The Scoliosis Research Society outcome instrument demonstrated good postoperative pain control, function, self-image, and satisfaction in both groups. CONCLUSION:No significant differences in radiologic and clinical outcome were found, in either group. Both procedures appear to be safe and effective surgically and radiographically.
journal_name
Spine (Phila Pa 1976)journal_title
Spineauthors
Rodriguez-Olaverri JC,Zimick NC,Merola A,Vicente J,Rodriguez J,Tabuenca A,Loste A,Suñen E,Burgos J,Hevia E,Piza-Vallespir Gdoi
10.1097/BRS.0b013e31817ecc01subject
Has Abstractpub_date
2008-08-15 00:00:00pages
1977-81issue
18eissn
0362-2436issn
1528-1159pii
00007632-200808150-00010journal_volume
33pub_type
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