Long-Term Clinical and Radiological Evaluation of Low-Grade Lumbar Spondylolisthesis Stabilization with Rigid Percutaneous Pedicle Screws.

Abstract

The armamentarium of surgical treatment options for lumbar spondylolisthesis (LS) includes decompression alone, stabilization with interlaminar devices, or instrumented fusion, through open or minimally invasive approaches. Despite its safe profuse use in distinctive lumbar spine disorders, using percutaneous pedicle screws (PPSs) alone to stabilize LS has never been described before. We performed a retrospective study of prospectively collected data, enrolling 24 patients with LS and scrutinizing clinical and radiological outcomes. A statistically significant decrease in visual analog scale (VAS) scores (p<0.001) and Oswestry Disability Index (ODI) scores (p<0.001) was observed, as was a reduction in the intake of acetaminophen after surgery (p=0.022). In the long-term, PPS effectively reduced the index-level range of motion (p<0.001), reduced preoperative slippage (p=0.03), and maintained foraminal height, thus accounting for the positive clinical outcomes. It induced a significant segmental kyphotic effect (p<0.001) that was compensated for by a favorable increase in the pelvic incidence minus lumbar lordosis (PI-LL) index (0.028).