Spine
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This study retrospectively examines outcomes of unilateral transforaminal lumbar interbody fusion (TLIF) with posterior fixation using anterior carbon fiber cages and 360 degrees fusion in spondylolisthesis. ⋯ Interbody cages in spondylolisthesis are useful to increase neuroforaminal height, to facilitate reduction, and to improve the chances of achieving a successful 360 degrees fusion.
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A prospective single arm cohort. OBJECTIVE.: To study the results of distraction reduction of high-grade isthmic dysplastic spondylolisthesis with posterior lumbar interbody fusion and posterior compression in a consecutive, prospectively collected series of adolescent patients. ⋯ The index procedure provided near-anatomic correction of high-grade spondylolisthesis, which is maintained at a minimum 2-year follow-up without significant complications. There were two structural complications. Anterior column structural support and posterior compressive instrumentation help restore the necessary biomechanics to allow clinical fusion and success. This series has led the senior author to evolve his technique too ften include caudad fixation to the pelvis and/or cephalad fixation to L4.
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A retrospective clinical study with a follow-up of more than 4 years was conducted. ⋯ All the intervertebral bone fusion after PLIF occurred inside the cages and in the posterior intervertebral space. We suggest the complete removal of discmaterial and deep insertion of the cages to create sufficient posterior intervertebral space for bone growth. PLIF using cages impacted with laminar bone chips is a useful method when considering the time required for surgery and the morbidity of the autograft donor sites.
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Mechanical testing of cadaveric motion segments. ⋯ IDET has a significant but inconsistent effect on compressive stresses within intervertebral discs. These results may partly explain the variable clinical success of IDET.
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Case Reports
Utilization of iliac screws and structural interbody grafting for revision spondylolisthesis surgery.
Retrospective case analysis and presentation. ⋯ For many of these cases of both high-grade dysplastic spondylolisthesis and low-grade adult isthmic spondylolisthesis, a reasonable combination of anterior column support and/or iliac screw fixation may be logical to reduce the incidence of failure and need for revision. The biggest concern with using iliac screw fixation is that these screws are prominent in a percentage of patients and the ultimate impact on the sacroiliac joint is not fully investigated. However, at our institution with 5- to 10-year follow-up, the impact on the sacroiliac joint has been minimal.