Comparison between Posterior Lumbar Interbody Fusion with Pedicle Screw Fixation and Posterolateral Fusion with Pedicle Screw Fixation in Spondylolytic Spondylolisthesis in Adults

Abstract

‐ Abstract ‐ Study design: This was a retrospective study that analyzed and compared the results between a posterior lumbar interbody fusion, and a posterolateral fusion (PLIF+PLF), and PLF alone, in the treatment of spondyolytic spondylolisthesis in adults. O b j e c t i v e s: To evaluate the outcomes of two surgical treatment methods for spondylolytic spondylolisthesis-posterolateral fusion alone, and circumferential fusion, using posterior lumbar interbody fusion and posterolateral fusion. Summary of Literature Review: There have been many reports regarding the surgical treatment of spondylolisthesis. Posterior lumbar interbody fusions have certain distinct mechanical advantages over posterolateral ones. However, the clinical and radiological results do not usually correlate. Materials and Methods: Between January 1998 and December 2001, 38 patients, with spondylolytic spondylolisthesis, were operated on by a single surgeon. Nineteen patients underwent a posterolateral fusion alone (group I), with the same number undergoing an additional posterior lumbar interbody fusion (group II). These two groups were evaluated for their clinical outcomes, radiological measurements and fusion rates. Results: The losses in the slip reduction were 7.1 and 1.3% in the PLF and PLF+PLIF groups, respectively (P 0.05). Conclusions: Although the addition of a posterior lumbar interbody fusion, to an instrumented posterolateral fusion, following decompression, is more predictable in maintaining a correction and achieving union, a posterolateral fusion may have a better clinical outcome in patients with low grade spondylolytic spondylolisthesis. Therefore, careful patient selection is necessary for each operation.