Outcomes of Lumbar Interbody Fusion and Posterior Instrumentation in Spondylolisthesis: A Prospective Study
Mohammad Sazzad Hossain1*, Erfanul Huq Siddiqui1, Sharif Md. Musa1, Shaik Forhad1
Integrative Biomedical Research (Journal of Angiotherapy) 6(2) 1-8 https://doi.org/10.25163/angiotherapy.6210296
Submitted: 12 July 2022 Revised: 26 July 2022 Published: 28 July 2022
Abstract
Background: Spondylolisthesis is a condition characterized by the anterior displacement of a vertebral body over the one beneath it, often resulting in pain, neurological deficits, and functional limitations. Lumbar interbody fusion (LIF) with posterior instrumentation has emerged as a standard surgical approach for patients who fail conservative treatment. This study aims to evaluate the clinical and radiological outcomes of LIF combined with posterior instrumentation in patients with spondylolisthesis. Methods: A prospective observational study was conducted at a tertiary care center in Bangladesh between January 2021 and January 2021. Forty patients diagnosed with Grade I or II spondylolisthesis underwent single- or two-level lumbar interbody fusion with posterior pedicle screw instrumentation. Preoperative and postoperative clinical outcomes were assessed using the Visual Analog Scale (VAS) for pain, Oswestry Disability Index (ODI) for functional status, and radiographic parameters for fusion assessment. Follow-up evaluations were conducted at 3 months, 6 months, and 12 months postoperatively. Results: There was a significant reduction in the mean VAS score from 7.6 ± 1.1 preoperatively to 2.1 ± 0.8 at 12 months (p < 0.001). The ODI scores improved from a mean of 62.4 ± 10.5 to 18.6 ± 6.9 (p < 0.001). Radiographic fusion was observed in 90% of patients at one-year follow-up. Complications included superficial infection (5%) and transient radiculopathy (7.5%), with no cases of implant failure or pseudarthrosis. Conclusion: Lumbar interbody fusion with posterior instrumentation is a safe and effective surgical intervention for spondylolisthesis, providing significant pain relief, functional improvement, and high fusion rates.
Keywords: Lumbar Interbody Fusion (LIF), Posterior Instrumentation, Spondylolisthesis, Spine Surgery
References
Boos, N., & Aebi, M. (2008). Spinal disorders: Fundamentals of diagnosis and treatment. Springer Science & Business Media.
Bridwell, K. H. (1997). Surgical treatment of lumbar degenerative spondylolisthesis with and without instrumentation. Spine, 22(24 Suppl), 110S–118S.
DePalma, M. J., Bhargava, A., & Empting, E. (2014). Risk factors for complications in lumbar interbody fusion: A systematic review. Pain Physician, 17(4), E411–E420.
Deyo, R. A., Mirza, S. K., Martin, B. I., et al. (2005). Trends, major medical complications, and charges associated with lumbar fusion surgery in Medicare beneficiaries. Spine, 30(20), 2327–2334.
Fredrickson, B. E., Baker, D., McHolick, R., Yuan, H. A., & Lubicky, J. P. (1984). The natural history of spondylolysis and spondylolisthesis. Journal of Bone and Joint Surgery - American Volume, 66(5), 699–707.
Frymoyer, J. W., Matsui, H., Nishiyama, M., et al. (1989). The adult spinal column: Characteristics and abnormalities. Seminars in Spine Surgery, 1(1), 1–10.
Ghogawala, Z., Dziura, J., Butler, W. E., et al. (2016). Laminectomy plus fusion versus laminectomy alone for lumbar spondylolisthesis. New England Journal of Medicine, 374(15), 1424–1434.
Gibson, J. N., & Waddell, G. (2005). Surgery for degenerative lumbar spondylosis: Updated Cochrane review. Spine, 30(10), 1135–1140.
Glassman, S. D., Berven, S., Bridwell, K., et al. (2005). Correlation of radiographic parameters and clinical symptoms in adult spinal deformity. Spine, 30(6), 684–691.
Glassman, S. D., Bridwell, K., Dimar, J. R., et al. (2005). The impact of positive sagittal balance in adult spinal deformity. Spine, 30(18), 2085–2092.
Hatta, T., Hoshino, M., Ohtori, S., et al. (2018). Long-term outcomes of single-level transforaminal lumbar interbody fusion for degenerative spondylolisthesis. Journal of Orthopaedic Science, 23(4), 618–623.
Hu, S. S. (1999). Internal fixation for spondylolisthesis. Spine, 24(16), 1618–1622.
Iguchi, T., Wakami, T., Kurihara, A., et al. (2002). Lumbar degenerative spondylolisthesis: Clinical and radiologic results of posterior lumbar interbody fusion. Spine, 27(5), 540–545.
Kalichman, L., Kim, D. H., Li, L., Hunter, D. J., Guermazi, A., & Wang, C. (2009). Spondylolysis and spondylolisthesis: A meta-analysis of the literature. The Spine Journal, 9(1), 154–162.
Kepler, C. K., Vaccaro, A. R., Hilibrand, A. S., et al. (2013). National trends in the use of lumbar interbody fusion techniques. Spine, 38(17), 1536–1542.
Liu, H., Lv, B., Zhang, Y., et al. (2014). Comparison of PLIF versus PLF in lumbar degenerative diseases: A systematic review and meta-analysis. European Spine Journal, 23(9), 1989–1996.
Meyerding, H. W. (1932). Spondylolisthesis. Surgery, Gynecology & Obstetrics, 54, 371–377.
Mummaneni, P. V., & Rodts, G. E. Jr. (2005). The mini-open transforaminal lumbar interbody fusion. Neurosurgery, 57(4 Suppl), 280–285.
Okuda, S., Oda, T., Miyauchi, A., et al. (2011). Lumbar degenerative spondylolisthesis: Risk factors for progression of slip. Spine, 36(19), 1576–1582.
Park, Y., & Ha, J. W. (2007). The efficacy of transforaminal lumbar interbody fusion in degenerative lumbar spondylolisthesis. Journal of Bone and Joint Surgery - British Volume, 89(12), 1598–1601.
Parker, S. L., Mendenhall, S. K., Shau, D. N., et al. (2014). Non-operative management of symptomatic degenerative lumbar spondylolisthesis: A systematic review and meta-analysis. The Spine Journal, 14(1), 21–29.
Pinter, Z. W., Bawa, M. S., Rynearson, N., et al. (2021). Fusion success rates with different interbody techniques: A systematic review. Journal of Neurosurgery: Spine, 35(4), 460–469.
Radcliff, K., Albert, T. J., Rihn, J. A., et al. (2013). Current management of degenerative lumbar spondylolisthesis. Orthopedic Clinics of North America, 44(3), 363–376.
Rahman, M. A., Hasan, Z., Rashid, M. A., et al. (2021). Outcomes of lumbar decompression, lumbar interbody fusion by bone graft with cage and stabilization by pedicle screws and rods in patients with lumbar spondylolisthesis: A prospective study. Mymensingh Medical Journal, 30(1), 152–159.
Rosenberg, W. S., & Mummaneni, P. V. (2001). Transforaminal lumbar interbody fusion: A new technique in spinal fusion. Neurosurgery, 49(1), 15–24.
Sairyo, K., Higo, Y., Higashino, K., et al. (2018). Long-term results of single-level posterior lumbar interbody fusion with posterior instrumentation for lumbar degenerative spondylolisthesis. The Spine Journal, 18(8), 1378–1383.
Schwab, F., Lafage, V., Farcy, J. P., et al. (2008). Sagittal plane spinal deformity. Neurosurgical Clinics of North America, 19(2), 271–285.
Schwab, F., Lafage, V., Protopsaltis, T., et al. (2013). Predictive factors for functional outcome after lumbar spinal fusion: A large cohort study. Spine, 38(11), 955–961.
Varlotta, G. P., Amato, M., Aliberti, F., & Bernardini, A. (2023). Spondylolisthesis: Current classification and treatment. Journal of Orthopaedic Science, 28(2), 227–238.
Wiltse, L. L., Newman, P. H., & Macnab, I. (1976). Classification of spondylolysis and spondylolisthesis. Clinical Orthopaedics and Related Research, 117, 23–29.
View Dimensions
View Altmetric
Save
Citation
View
Share