The Journal of Bone and Joint Surgery, Vol 72, Issue 3 415-421, Copyright © 1990 by Journal of Bone and Joint Surgery, Inc
Spondylolisthesis treated by a single-stage operation combining decompression with in situ posterolateral and anterior fusion. An analysis of eleven patients who had long-term follow-up
MD Smith and HH Bohlman
Case Western Reserve University Hospitals, Cleveland, Ohio.
We treated eleven skeletally mature patients who had a high-grade
lumbosacral spondylolisthesis by a single-stage operation that involved
posterior spinal decompression, posterolateral arthrodesis with autogenous
iliac-crest graft, and anterior arthrodesis with a fibular graft inserted
from the posterior approach. We did not attempt to correct the deformity.
Preoperatively, all but one patient had severe pain in the back and lower
limb; the exceptional patient had severe pain only in the low back. All but
one patient had sensory deficits and objective motor impairment before the
operation, and five had cauda equina syndrome. Six patients had had a
previous operation that had failed. The duration of follow-up ranged from
two to twelve years. A solid fusion was obtained in all patients, and all
had major or complete neurological recovery. The results did not
deteriorate with time.
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