Abstract
Objectives: The aim of this study was to determine the outcome of posterior lumbar interbody fusion using an intrasegmental pedicle screw device in a series of patients with symptomatic spondylolisthesis.
Design: Prospective Case Series.
Subjects: 34 consecutive patients underwent posterior lumbar fusion for symptomatic spondylolisthesis using an intrasegmental pedicle screw device between December 1998 and January 2002. The mean age was 48.6 (range 27–84) and 16 were male and 18 female. 22 patients had a spondylolisthesis at the L5/S1 level, 10 at the L4/5 level, 1 at the L3/4 level, 1 at the L2/3 level. 17 patients had a grade 1 slip, 16 grade 2, and 1 grade 3. 22 patients had a single intervertebral level fused, 10 two levels and 2 three levels.
Outcome Measures: Fusion status was assessed using radiographs (lateral, AP and in the plain if the intervertebral disc). To be judged as fused, there had to be an absence of metalwork failure, pedicle screw loosening and fusion at all levels if a multi-level fusion.
Patient outcome was assessed by means of a visual analogue scale (VAS) for pain, SF36 health assessment questionnaire, a patient subjective outcome assessment, employment status and analgesic usage.
Results: Fusion was successfully achieved in 33 (97%) patients.
The mean VAS reduced by 3.2 points from 8.3 to 5.1 (p=0.0001). There was a significant improvement in all the physical component scores of the SF36. The subjective outcome was either excellent or good in 24 (71%) patients. Of the 26 patients working prior to surgery, 20 (77%) returned to work. Analgesia usage reduced in 21 (61%) patients.
One patient died in the post operative period.
Conclusions: Our study supports the view that good clinical outcomes can be achieved by posterior interbody fusion of symptomatic spondylolisthesis. This particular intrasegmental device enables a safe, simple technique for reduction and fusion of symptomatic spondylolisthesis.
The abstracts were prepared by Mr Peter Millner. Correspondence should be addressed to Peter Millner, Consultant Spinal Surgeon, Orthopaedic Surgery, Chancellor Wing, Ward 28 Office Suite, St James’ University Hospital, Beckett Street, Leeds LS9 7TF.
