KMID : 0388720070140030178
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Journal of Korean Society of Spine Surgery 2007 Volume.14 No. 3 p.178 ~ p.186
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More than 5 year-Follow-Up After Pedicle Screw Fixation and Fusion for Isthmic Spondylolisthesis
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Lee Jae-Chul
Soh Jae-Wan Kim Yun-Il Shin Byung-Joon Hwang Seok-Ha
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Abstract
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Study Design: A retrospective study.
Objectives: The aim of this study was to analyze the long term follow-up results of the isthmic spondylolisthesis patients who had been treated with pedicle screw fixation and fusion, and were followed up for more than 5 years. An attempt was made to determine the differences between posterior lumbar interbod fusion(PLIF) and posterolateral fusion (PLF).
Summary of Literature Review: The surgical treatment of isthmic spondylolisthesis has developed markedly after the introduction of spine fusion and pedicle screw fixation. However, the long-term prognosis after such treatments has not been investigated sufficiently.
Materials and Methods: Among 53 patients, 38(72%) patients were examined more than 5 years after surgery. The clinical results were evaluated according to Kim¡¯s criteria. Radiologically, the degree of slippage and disc height was measured. The changes in the adjacent segments were also observed.
Results: PLIF was performed in 26 patients and PLF was performed in 12 patients. In the PLIF group, the clinical results were ¡®excellent¡¯ in 15 patients, ¡®good¡¯ in 8, ¡®fair¡¯ in 2, and ¡®poor¡¯ in 1. In the PLF group, the results were ¡®excellent¡¯ in 8 patients, ¡®good¡¯ in 2, ¡®fair¡¯ in 1, and ¡®poor¡¯ in 1. According to the fusion method, a satisfactory outcome was obtained in 89% of patients in the PLIF group, and 83% in the PLF group, without any statistically significant differences. Radiological analysis was available in 28 (52.8%) patients. There were no statistically significant differences between the PLIF and PLF groups in terms of the reduction and maintenance of slippage and the disc height.
Conclusions: The clinical result of isthmic spondylolisthesis patients who were treated with pedicle screws and fusion were satisfactory in 87% of patients. The clinical and radiological comparison of the fusion methods showed no significant differences between the PLIF and PLF groups.
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KEYWORD
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Isthmic spondylolisthesis, Pedicle screw fixation, Posterior lumbar interbody fusion, Posterolateral fusion
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