Treatment of lumbar spondylolisthesis with spondylolisthesis reduction system internal fixation and decompression, posterior alone interbody cage fusion and bone grafting

Objective: To investigate the clinical outcomes of lumbar spondylolisthesis associated with lumbar spinal stenosis through decompressive laminectomy, spondylolithesis reduction system (SRS) internal fixation, single posterolateral Vigor Spacer threaded fusion cages and intertransverse process arthrodesis bone grafting.

Methods: From June 2002 to June 2006, 58 cases of lumbar spondylolisthesis were treated with decompressive laminectomy, fixed by SRS instrumentation, posterior installed with interbody Vigor Spacer Cage and bone grafted between intertransverse process arthrodesis. There were 47 males and 11 females, aged 32-66 years old (45.8 on average). The course of disease was 3 months to 7 years, with an medium course of 25 months. According to the Meyerding standard, 38 cases were classified as degree I and 20 as degree II. Spondylolisthesis between L4 and L5 covered 21 cases and between L5 and S1 covered 37 cases. There were 44 cases of lumbar spondylolisthesis and 14 of degenerative lumbar spondylolisthesis. The intervertebral height was 1.5-10.5 mm with the average of 5.1 mm.

Results: All patients' incisions obtained healing by first intension after operation. The operation time was 50-90 minutes with an average of 65 minutes. The blood loss was 200-500 mL with an average of 250 mL. The patients were followed up for 10-38 months with an average of 23.6 months. According to the Macnab criteria, 54 cases were excellent, 3 good, 1 fair and the choiceness rate was 98.3%. According to the Meyerding classification, 38 cases of degree I and 19 out of 20 cases of degree II obtained complete reduction, and the rate of complete reduction was 98.3%. There were 57 (98.3%) cases which fused well 3-6 months after operation. The intervertebral height resumed to 9.6-12.5 mm with an average of 11.6 mm, and no intervertebral height loss was found.

Conclusions: The treatment of lumbar spondylolisthesis with decompressive laminectomy, SRS internal fixation, single posterior lateral Vigor Spacer threaded fusion cage and bone grafting has excellent clinical results and stable reduction.