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.

Introduction: Treatment of choice in osteogenesis imperfecta (O.I.) patients presenting severe deformities of lower limbs is endomedular nailing with previous corrective osteotomy. Fassier-Duval telescopic rod permits anterograde nailing without the need of distal arthrotomy and thus, joint damage.

MATERIAL AND Methods: We retrospectively revised the first 14 rods implanted in 9 patients at our service, 6 males and 3 females. Average age of 6.14 years. Sillence type III: 5, type IV: 4. Six right femurs, 7 left femurs and one tibia were nailed. In 5 of the 14 cases surgery was performed on acute fractures on previous deformities, in 9 cases because of progressive deformities. Corrective osteotomies were performed in all cases. Seven of 9 patients were receiving treatment with palmidronate prior to surgery. Improvement in quality of life with Bleck scale was assessed.

Results: Six of 14 operations were salvage procedures because of failure of other implants. Complications included a transient sciatic palsy, lack of telescoping in one case, one acute fracture with implant failure and one delay in consolidation. Two reoperations were needed. Global Bleck score improved from 7.37 to 12.75 (p=0.024), walking score improved from 1.25 to 2.87 (p=0.038).

DISCUSSION AND Conclusions: Fassier-Duval telescopic rod is a safe and useful implant for the treatment of deformities in the lower limbs in patients with O.I. There was a significant improvement in both global quality of life score and walking score.