In situ posterolateral spine arthrodesis for grades III, IV, and V spondylolisthesis in children and adolescents

The purpose of the study was to analyze the results after in situ posterola teral arthrodesis without reduction in children and adolescents with Meyerd ing grades III and IV spondylolisthesis and in patients with spondyloptosis who had an average follow-up of 12.8 years. The study population consisted of 21 patients who underwent an in situ posterolateral spinal fusion from L4 to S1 with autogenous iliac bone graft and were immobilized in a pantalo on cast for 4 months. All patients reported improvement after the operation and had no limitation in daily activities. Only Four of 21 patients compla ined of occasional mild pain after physical activity, which resolved with r est and did not disturb their work. After surgery there were no motor defic its, incontinence of bowel or bladder, or sexual dysfunction. Roentgenograp hic findings showed progression of the slip in five patients and increase o f the slip angle and the displacement index in two patients. These changes happened during the first year after the operation. progression of the slip was not associated with symptoms. There was no pseudarthrosis. Tn situ pos terolateral arthrodesis with a large amount of autogenous bone graft follow ed by immobilization in a pantaloon cast yields a solid arthrodesis and pro vides satisfactory results.