Aim of this study is to assess and compare the outcomes of posterior lumbar interbody fusion (PLIF) and posterolateral fusion (PLF) in adult isthmic spondylosthesis. BACKGROUND: Posterolateral fusion has been considered the best method and widely been used for surgical treatment of adult spondylolisthesis.Superior results have subsequently been reported with interbody fusion with cages and posterior instrumentation MATERIALS AND METHODS: Thirty six patients with isthmic spondylolisthesis were operated. One group (20 patients) had decompression and posterolateral fusion (PLF) with a pedicle screw system; other group (16 patients) was treated by decompression, posterior lumbar interbody fusion (PLIF) and a Pedicle screw system. In both groups adequate decompression was done RESULTS: Seventy seven percent of the patients had a good result with (PLIF) and 68 percent with posterolateral fusion (PLF). However there was no statistical difference in cases with low grade slipping, whereas the difference was significant for cases with high grade slipping. Fusion rate was 93% with (PLIF) and 68% with (PLF), but without any significant incidence in the functional outcome. 78% has relief of sciatica and neurogenic claudication. CONCLUSION: Based on these findings we found that for high grade spondylolisthesis which requires reduction or if the disc space is still high posterior lumbar inter body fusion is preferable. For low grade spondylolisthesis or if the disc space is narrow posterolateral fusion is preferable. A successful result of fusion operation depends on adequate decompression which relieves radicular symptoms.
BACKGROUND/AIM: ACL repair using Hamstring tendon autograft is very well known. Our study aims to find the outcome of ACL injuries treated in our unit arthroscopically with anatomic 4 strand hamstring autograft fixed with RCI screw. SETTINGS AND DESIGN: Prospective/case series. MATERIALS AND METHODS: First 20 patients out of 88 cases (operated between 2008 and 2010) were taken for the study. Patients with isolated ACL injuries were included. Patients with bony ACL avulsion/other associated fractures/ ligamentous / meniscal injuries were excluded from our study. The final outcome was done using IKDC subjective scoring and Lysholm knee scoring systems at the end of 24 months of follow up. The preferred method of fixation was RCI screw as it provides aperture fixation. STATISTICAL ANALYSIS: Kruskaal wall is test, linear regression. RESULTS: In our study groups of 20 cases of Arthroscopic ACL reconstruction, Majority of the patients (12 cases) were in the age group between 21-30 years-indicates that young and active people were most often involved. Males were injured more commonly than females. Sports injuries were the common cause of ACL injury closely followed by RTA. Right knee was found to be involved more than Left. CONCLUSION: ACL reconstruction by using four strand hamstring tendon autograft is highly successful with very few complications when proper graft, harvest preparation and anatomical tunnel placement and secure fixation are achieved.
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