The Comparison of Clinical and Radiologic Results Classified by Translation Type and Fusion Method in the Isthmic Spondylolisthesis

ABSTRACT

STUDY DESIGN: A retrospective study. OBJECTIVES: To examine the radiologic and clinical results of patients classified as excessive translation and excessive angulation, treated by posterolateral fusion only, or posterolateral fusion with posterior lumbar interbody fusion in isthmic spondylolisthesis. SUMMARY OF LITERATURE REVIEW: Isthmic spondylolisthesis is usually treated by PLF only or PLF with PLIF. But it is not reported the clinical and radiologic results classified by translation type. MATERIALS AND METHODS: Patients who had received surgery for spondylolisthesis between January 2005 to January 2010, there were 56 for whom follow-up observations were possible for 2 years. According to the fusion methods and preoperative flexion-extension simple radiograph, we classified as excessive translation and excessive angulation by segmental instability and as PLF and PLIF by surgical methods. We examine the clinical results(Visual Analogue Scale, Oswestry Distability Index, operation time, blood loss, complication rate) and the radiologic results(reduction rate of slippage, change of segmental angle, reduction ratio of disc height, bone union). RESULTS: In radiologic results, excessive angulation(group II) did not show significant difference from excessive translation(group I) in terms of reduction rate of slippage, change of segmental angle, reduction ratio of disc height, bone union. But we found excessive translation-PLIF(group I-B) was better than excessive translation-PLF(group I-A) and excessive angulation-PLIF(group II-B) was better than excessive angulation-PLF(II-A) in terms of reduction ratio of disc height(P<0.05). In clinical results, both sides group did not show significant difference in operation time, blood loss, complication rate. CONCLUSIONS: In spondylolisthesis patients, excessive translation group(I) and excessive angulation group(II) did not show significant difference in radiologic results and clinical results. But both sides group showed the PLF with PLIF was better than the PLF only in terms of reduction ratio of disc height.