Fusion and clinical outcomes of lumbar interbody fusion for low-grade isthmic spondylolisthesis

被引：6

作者：

Ould-Slimane, Mourad ^{[1
]}

Prost, Solene ^{[2
]}

d'Astorg, Henri ^{[3
]}

Lalevee, Matthieu ^{[1
]}

Blondel, Benjamin ^{[2
]}

Szadkowski, Marc ^{[3
]}

Fuentes, Stephane ^{[2
]}

Collinet, Arnaud ^{[4
]}

Parent, Henry-Francois ^{[5
]}

Litrico, Stephane ^{[6
]}

Grelat, Michael ^{[7
]}

Zairi, Fahed ^{[8
]}

Charles, Yann-Philippe ^{[4
]}

Giorgi, Hadrien ^{[9
]}

机构：

[1] Rouen Univ Hosp, Dept Orthoped Surg, Spine Unit, Rouen, France

[2] Aix Marseille Univ, CHU Timone, AP HM, CNRS,ISM,Unite Chirurg Rachidienne, 264 Rue St Pierre, F-13005 Marseille, France

[3] Hop Prive Jean Mermoz, Ctr Orthoped Santy, Ramsay Gen Sante, Lyon, France

[4] Hop Univ Strasbourg, Serv Chirurg Rachis, Hautepierre 2,1 Ave Moliere, F-67200 Strasbourg, France

[5] Clin St Leonard, 18 Rue Belliniere, F-49800 Trelaze, France

[6] Ctr Hosp Univ Nice, Pasteur Hosp 2, Dept Spine Surg, Nice, France

[7] Dijon Univ Hosp, Dept Neurosurg, Dijon, France

[8] Hop Prive Le Bois, Ramsay Gen Sante, F-59000 Lille, France

[9] Inst Mediterraneen Dos, Marseille, France

[10] 56 Rue Boissonade, F-75014 Paris, France

来源：

ORTHOPAEDICS & TRAUMATOLOGY-SURGERY & RESEARCH | 2023年 / 109卷 / 02期

关键词：

Isthmic spondylolisthesis; Interbody fusion; Arthrodesis; Surgery; Clinical outcomes; MANAGEMENT; POSTERIOR;

D O I：

10.1016/j.otsr.2022.103508

中图分类号：

R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学（修复外科学）];

学科分类号：

摘要：

Introduction: Low-grade isthmic spondylolisthesis (ISPL) is generally treated by circumferential fusion with interbody graft, although there is no consensus on technique.Hypothesis: The various interbody fusion strategies provide satisfactory fusion rates and clinical results. Methods: A multicenter retrospective study analyzed lumbar interbody fusion for low-grade ISPL per-formed between March 2016 and March 2019. Techniques comprised: circumferential fusion on a posterior or a transforaminal approach (PLIF, TLIF: n = 57), combined anterior (ALIF) + posterolateral fusion (ALIF + PLF: n = 60), and ALIF + percutaneous posterior fixation (ALIF + PPF: n = 55). Function was assessed on a lumbar and a radicular visual analog scale (AVS-L, VAS-R), Oswestry Disability Index (ODI) and Short Form 12 (SF12).Results: Among the 129 patients, 85.3% showed fusion (Lenke 1 or 2), with no significant differences between the ALIF-PLF or ALIF-PPF groups and the PLIF or TLIF groups (p = 0.3). Likewise, there was no difference in fusion rates between the ALIF-PPF and ALIF-PLF subgroups (p = 0.28). VAS-L (p < 0.001) and VAS-R (p < 0.0001), ODI (p < 0.001) and SF12 physical (PCS) (p < 0.01) and mental component sores (MCS) (p < 0.001) all showed significant improvement at 12 months. Combined approaches provided greater clinical efficacy than TLIF or PLIF for lumbar (p < 0.0001) and radicular pain (p < 0.05), ODI (p < 0.0001) and SF12 PCS (p < 0.01). At 12 months, there was no clinical difference between the ALIF-PPF and ALIF-PLF subgroups. However, patents with interbody non-union (Lenke 3 or 4) had lower SF12 PCS scores (p < 0.004) and VAS-L ratings (p < 0.001) than Lenke 1-2 patients.Conclusion: Low-grade ISPL treated by circumferential arthrodesis and interbody graft showed 85.3% consolidation at 2 years, with equivalent outcomes between anterior and posterior techniques. Successful fusion was associated with better clinical results. Level of evidence: IV.(c) 2022 Published by Elsevier Masson SAS.

引用

页数：6