Abstract
Introduction: The need for reduction of high grade spondyloisthesis continues to be a source of debate. Recent papers report on better outcomes with “in situ” fusion.
MATERIAL AND Methods: We retrospectively revised 17 patients treated for high grade spondylolisthesis. Average age 16.3 years, average follow-up 76.4 months. Average slip was 78.47%. Posterior approach in 14, double approach in 3. L4-S1 fusion in 16. In 3 patients posterior fusion with double fibular graft and screws was performed. Reduction was performed in 14 cases. Radiographic, clinical data and complications were assessed.
Results: Slip improved from 75.07% to 41.3% (44% correction, p=0.001) and slip angle measured in the superior end plate of L5 from 17.7% to 8.3% (53.1% correction, p=0.05) in the reduction group. There were no permanent neurological complications and no dural tears. Global SRS-22 scores were 4.28 in the reduction group and 4.03 in the non reduction group (p=0.14), satisfaction with the treatment was 4.4. Two patients had to be reoperated because of implant failure and progression. Two asymptomatic screw breaks were noted.
DISCUSSION AND Conclusions: We believe that partial reduction of high grade spondylolisthesis can be safely obtained with a correct surgical technique, rendering slightly better results than “in situ” fusion with no increase in complications.
Correspondence should be addressed to Ms Larissa Welti, Scientific Secretary, EFORT Central Office, Technoparkstrasse 1, CH-8005 Zürich, Switzerland
