Comparative study between recapping inter body fusion and posterolateral fusion in cases of spondylolysis and lytic listhesis

Abstract

Background Spondylolysis and lytic spondylolisthesis are common orthopedic problems. Nonsurgical methods and physiotherapy always fail. Surgical options include laminectomy (obsolete), noninstrumented fusion, posterolateral fusion (PLF), posterior lumbar interbody fusion (PLIF), transforaminal lumbar interbody fusion, anterior lumber interbody fusion, and other techniques. Most of them are successful, but each has its own advantages and disadvantages. PLIF is a successful method but carries the disadvantage of disruption of the posterior column and leaving the dura uncovered.Aim The aim of the study was to analyze the results of recapping technique and comparing the results with PLF regarding. Surgical time, blood loss, complications, pain relief, and fusion rate were recorded.Patients and methods A comparative study between 15 patients with PLF and 15 patients with recapping PLIF was done. Follow-up and radiograph were done at 2 weeks, 3 months, 6, and 12 months. When pseudoarthrosis was suspected, a computed tomography scan was done (two cases).Results Surgical time and blood loss were more in the recapping groups, in which one case of dural injury was recorded but no cases of pseudoarthrosis. Moreover, two cases of pseudoarthrosis were recorded in the PLF group. Early pain relief was more in the PLF group, but late improvement was similar in both groups.Conclusion Recapping PLIF can restore the three columns of the spine. It provides canal clearance as anterior lumber interbody fusion, carries low risks, and ensures good stability. It also provides wide surface for fusion, with preservation of the important mechanical roles of the posterior structure than do classic PLIF, with superior results of PLF group in the short term but superior results for recapping in the long-term follow-up.