TRANSPEDICULAR FIXATION FOR THE TREATMENT OF ISTHMIC SPONDYLOLISTHESIS IN ADULTS

Study Design. This study analyzed the fusion rate and clinical success rate in adult patients undergoing surgical treatment for symptomatic, low grade, isthmic spondylolisthesis. A postoperative questionnaire a nd grading scale were used to judge clinical success. Successful fusio n was judged using radiographic criteria. Objective. To evaluate the c linical success and fusion success In a group of adult patients underg oing instrumented posterolateral arthrodesis for symptomatic isthmic s pondylolisthesis. Summary of Background Data. Seventeen consecutive ad ult patients with symptomatic low grade isthmic spondylolisthesis unde rwent the identical surgical procedure consisting of Gill laminectomy, L5 nerve root decompression, Luque pedicle-screw plate instrumentatio n, and posterolateral arthrodesis at L5-S1 using autogenous iliac cres t bone graft. Results were analyzed at an average 30-month follow-up. Methods. An independent observer reviewed the results using a postoper ative questionnaire to determine rates of return to work, symptom reli ef, and analgesic medication usage. Radiographs were evaluated to dete rmine the fusion status.Results. Seventeen patients were evaluated at an average of 30 months after the index procedure. Sixteen of 17 had s olid fusions using radiographic criteria. Sixteen of 17 had satisfacto ry clinical results. Eight of 13 (62%) employed patients, including th ree of six patients with worker's compensation, returned to their usua l jobs. Conclusions. An instrumented posterolateral arthrodesis in com bination with a Gill procedure and L5 nerve root decompression results in a high rate of fusion satisfactory clinical success, and a high ra te of return to work.