Spinous process plate (S-plate) fixation after posterior interbody fusion for lumbar canal stenosis due to spondylolisthesis

Abstract

In operations for lumbar canal stenosis due to spondylolisthesis with instability, internal fixation of the lumbar spine has been attempted after lumbar posterior decompression, as lumbar posterior decompression would worsen the instability and thus limit functional improvement postoperatively. In these cases, we have been performing lumbar posterior decompression followed by posterior lumbar interbody fusion (PLIF) with pedicle screws (PSs). However, cases where the patient has osteoporotic bone carry a high risk of complications such as backing out of screws and fracture of pedicles after performing PS fixation. In such cases, we use a spinous process plate (S-plate; Kisco DIR, Osaka, Japan) instead of PSs (Fig. 1). In this paper, we describe our surgical strategy for lumbar spondylolisthesis with instability using the S-plate and present our results for this procedure. Clinical materials and methods