Long-term Outcome After Posterolateral, Anterior, and Circumferential Fusion for High-Grade Isthmic Spondylolisthesis in Children and Adolescents

Abstract

The clinical outcome was best in the CF group as measured by ODI. Degenerative changes were most commonly found at the level of the slip and above the fusion level. The prevalence of disc prolapses was low. Spinal fusion for isthmic spondylolysis is not associated with central canal stenosis above the fusion. Radiologic nerve root stenosis was common but asymptomatic. Mild muscle atrophy was common.

Outcomes of posterior facet versus pedicle screw fixation of circumferential fusion: a cohort study

“…Experimental animal studies have found magnetic resonance imaging (MRI) changes due to denervation and myonecrosis of the posterior spinal musculature consequent to posterior surgery and retraction duration [10,11]. Human MRI studies have also detected posterior spinal muscle abnormalities [12][13][14][15].…”

Functional outcome following direct repair or intervertebral fusion for adolescent spondylolysis

“…It appears that these studies report the same patient group from different perspectives. Remes et al [26] compared outcomes with abnormal MRI findings, Lamberg et al [25] examined functional and radiological outcomes, whereas Helenius et al [23] compared ODI to the Scoliosis Research Council (SRC) questionnaire. The postoperative mean ODI ranged from 6.3 for posterolateral fusions to 11.3 for posterior fusions.…”

“Reverse Bohlman” technique for the treatment of high grade spondylolisthesis in an adult population

“…Although circumferential fusion procedures often produce high rates of clinical and radiographic fusion, for higher-grade spondylolisthesis, slip severity may preclude direct anterior interbody fusion. [5][6][7][8] In 1938, Speed reported experiences in performing in situ fusion through an anterior approach using a tibial autograft strut to stabilize L5-S1 spondylolisthesis. 9 In 1982, Bohlman and Cook modified this protocol for spondyloptosis using a single incision posterior approach via introducing a fibular autograft across S1 into the L5 vertebral body in conjunction with a decompression and uninstrumented L4-S1 posterolateral fusion allowing for three column spinal fixation.…”