Abstract
A common consensus has not yet been reached on surgical management of isthmic Spondylolisthesis especially regarding the optimal surgical procedure. This prospective study was carried to see the outcome of Posterolateral fusion with instrumentation without decompression. Eight consecutive patients, aged between 43 to 55 years, underwent primary surgery for isolated L4, L5 lumbar isthmic Spondylolisthesis of less than grade II that presented with radicular pain and exhibited instability on dynamic radiograph. The surgical procedure consisted of instrumentation with pedicle screws and rods (Moss Miami System) and posterolateral fusion in situ by placement of autogeneous bone graft, harvested from posterior iliac crest. Postoperatively Clinical and Radiological status were assessed and were graded according to Stauffer and Coventry method. The patients were followed up for one to three years. Radiological evidence of fusion was clearly evident by six months in all cases. Symptomatically all were relieved of radicular pain completely. One patient had recurrent backache due to causes unrelated to the illness of surgical procedure requiring occasional analgesic. No serious complication was encountered. This lead to conclusion that in adults of our population with low grade isthmic spondylolisthesis and radicular pain Instrumentation with Posterolateral fusion without decompression was sufficient to relieve symptoms.
Highlights
Spondylolisthesis is defined as the forward slippage of all or part of one vertebra on another.[1]
When the slippage is due to a defect of the pars inter-articularis, it is referred to as isthmic spondylolisthesis.[2]
When the symptoms are severe enough to interfere with the patients essential activities, a multitude of surgical procedures have been proposed for their treatment
Summary
Spondylolisthesis is defined as the forward slippage of all or part of one vertebra on another.[1]. Some authors have recommended decompression and arthrodesis while others have recommended arthrodesis alone.[4,7,10,17] The aim of this study was to see the outcome of stabilization and arthrodesis without decompression
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