The Journal of Bone and Joint Surgery, Vol 69, Issue 7 960-969, Copyright © 1987 by Journal of Bone and Joint Surgery, Inc
Long-term follow-up of patients with grade-III and IV spondylolisthesis. Treatment with and without posterior fusion
IE Harris and SL Weinstein
Department of Orthopaedics, University of Iowa Hospitals and Clinics, Iowa City 52242.
The outcome in eleven patients in whom Grade-III and IV spondylolisthesis
was treated non-operatively (Group I) was compared with that in twenty-one
patients in whom the same degrees of spondylolisthesis were treated by
posterior interlaminar fusion (Group II). At an average eighteen-year
follow-up of the eleven patients in Group I, four (36 per cent) were
asymptomatic, six (55 per cent) had mild symptoms, and only one had
significant symptoms. Five (45 per cent) had one or more neurological
findings, but none were incontinent. All of the patients in this group led
an active life, and all had required only minor adjustments in their
life-style. At an average twenty-four-year follow-up of the twenty-one
patients in Group II, twelve (57 per cent) were asymptomatic, eight (38 per
cent) had mild symptoms, and only one had significant symptoms. Nine (50
per cent) of the eighteen patients who had a physical examination had one
or more neurological findings. Roentgenographically demonstrated failure of
fusion did not adversely affect the results, and the patients remained
asymptomatic despite the development of pseudarthrosis in one patient and
bending of the fusion mass in three (14 per cent). In situ arthrodesis
provides acceptable results for the patient who has Grade-III or IV
spondylolisthesis and pain that interferes with life-style and that is
unresponsive to non-operative treatment. In the skeletally immature
patient, in situ fusion is recommended for disturbances of gait secondary
to tight hamstrings and when the spondylolisthesis progresses.
CiteULike 
Connotea 
Del.icio.us 
Technorati What's this?
