Background: Spondylolisthesis primarily results from the
gradual misalignment of vertebral bodies, particularly in the
lumbar region. Degenerative and isthmic variants constitute
approximately 90% of these vertebral displacements. This condition is prevalent in 20.7% of individuals aged 40 to 80 years,
though only a subset of symptomatic patients necessitates surgical intervention. The preferred surgical approach for managing degenerative spondylolisthesis (DS) continues to be contentious. Typically, a strategy involving decompression along
with posterolateral fusion (PLF), optionally complemented by
lumbar interbody fusion, is widely adopted.
Aim of Study: This retrospective analysis was conducted to
evaluate and contrast the outcomes between patients who underwent isolated PLF and those who received a combination
of posterolateral fusion with interbody fusion (PLF + PLIF) for
the management of degenerative spondylolisthesis.
Patients and Methods: The study was conducted over a period of 36 months from August 2020 to August 2023 on 58 patients having single level degenerative lumbar spondylolisthesis whom were operated in neurosurgery department in Banha
University for decompression and posterolateral fusion with or
without posterior interbody fusion.
Results: While individuals undergoing PLF displayed a
more pronounced postoperative recovery in conditions such
as radiculopathy, bowel/bladder dysfunction, sensory anomalies, motor impairments, and back pain when compared to their
counterparts receiving PLF + PLIF, these variations failed to
reach a level of statistical significance. Nonetheless, the frequency of pseudoarthrosis/instrumentation failure and the necessity for subsequent surgical interventions were significantly
elevated within the PLF cohort. Radicular and neurological outcomes were statistically comparable between the two cohorts.
Conclusion: In cases of low-grade degenerative spondylolisthesis, posterolateral fusion tends to yield superior clinical outcomes; however, posterior lumbar interbody fusion
offers a more reliable approach for sustaining alignment correction and achieving successful union. Thus, meticulous patient
selection is critical for determining the appropriate surgical intervention. |
