Posterior lumbar interbody fusion versus XXXX with instrumentation in the treatment of low-grade isthmic spondylolisthesis: midterm clinical outcomes.

@entity1 @entity1643 @entity2649 @entity11375 @entity260 @entity13549 @entity613 @entity6357 @entity1515 @entity702 @entity717
OBJECT: The purpose of this study was to compare the methods of @entity2649 ( @entity2649 ) and @entity11375 ( @entity11375 ) in cases of isthmic Grades 1 and 2 lumbar spondylolisthesis, and to evaluate the clinical efficacy of the procedures. METHODS: Operations were performed in 50 @entity1 with lumbar spondylolisthesis in the authors' clinics between 2001 and 2007. Indications for surgery were @entity1643 with or without @entity13549 and @entity613 that had not improved after at least 6 months of conservative treatment. The study included 33 female and 17 male @entity1 , with mean ages of 50.6 years in the @entity2649 group and 47.3 years in the @entity11375 group. These @entity1 were randomly allocated into 2 groups: decompression, posterior transpedicular instrumentation, and @entity11375 (Group 1; 25 @entity1 ) and decompression, posterior transpedicular instrumentation, and @entity2649 (Group 2; 25 @entity1 ). In the @entity2649 group, @entity702 cages were used, and autograft material was obtained from the decompression. In the @entity11375 group, bone fragments collected from the iliac crest were used as autografts. A minimum 18-month follow-up was available in all @entity1 . For clinical evaluation, a visual analog scale, @entity717 Index, and the 36-Item Short Form Health Survey were used. Improvements in pre- and postoperative spondylolisthesis, segmental angles, fusion ratios, and @entity260 were evaluated radiologically. RESULTS: The average follow-up period was 3.3 years. Based on the etiologies, isthmic spondylolisthesis was detected in all @entity1 . The spondylolisthesis levels in the @entity1 who underwent @entity2649 were located at @entity6357 (5 @entity1 , 20%); L4-5 (14, 56%); and L5-S1 (6, 24%), whereas the levels in the ones treated with @entity11375 were located at @entity6357 (4 @entity1 , 16%); L4-5 (13, 52%); and L5-S1 (8, 32%). In the clinical evaluations, good or excellent results were obtained in 22 (88%) cases in the @entity2649 group and 19 (76%) cases in the @entity11375 group. Fusion ratios were 100% in the @entity2649 group and 84% in the @entity11375 group. Both lumbar @entity1515 and the segmental angle showed greater improvement in the @entity2649 group. There was no difference in the complication rates for each group. CONCLUSIONS: Based on early clinical outcomes and the fusion ratios of adult isthmic spondylolisthesis, the authors found @entity2649 to be superior to @entity11375 .
