Comparison of Clinical Outcome: Posterolateral Fusion with Transpedicular Screw Fixation and Cage Interbody Fusion with Transpedicular Screw Fixation in Adult Spondylolithesis

Kyoung–Suok Cho, MD, PhD
Chun–Kun Park, MD, PHD
Choon–Keun Park, MD, PHD
Sung–Chan Park, MD, PHD
Chul–Ji, MD, PHD
Do–Sung Yoo, MD, PHD
Pil–Woo Huh, MD, PHD
Dal–Soo Kim, MD, PHD
Joon–Ki Kang, MD, PHD, (Seoul, KOREA)

Introduction:

The usefulness of pedicle screw instrumentation has been well documented since mid–1980. We compare the clinical and radiological results between pedicle screw fixation with posterolateral fusion and pedicle screw fixation with cage posterolateral interbody fusion in adult spondylolithesis.

Material and Method:

The clinical data of 60 adult patients who had undergone operations for adult spondylolithesis for 5 years were reviewed. Surgery was performed in case of radiological and clinical instability. Pedicle screw fixation with posterolateral fusion was performed in 30 patients (Group 1) and pedicle screw fixation with cage posterolateral interbody fusion in 30 patients (Group 2). The mean age of patients was 57 years (range 31 –71) in Group 1 and 53.5 years (range 21–69) in Group 2. Sex ratios (male:female) were 13:17 in Group 1 and 10:20 in Group 2. The average follow periods were 31 months in Group 1 and 24 months in Group 2.

Results:

The fusion rate 1 year after surgery was 90% in Group l and 95% in Group 2. The correction of anterior slippage from preoperative to postoperative slippage by Taillard method was from 17.9% to 10.4% in Group 1, and from 17.2% to 2% in Group 2 (P<0.01). The clinical improvement after surgery was assessed by Prolo's outcome scale. The satisfactory results were obtained 85% in Group 1 and 90% in Group 2.

Conclusion:

Operative results were satisfactory in both groups. There were no statistical significant differences in clinical and radiological results between pedicle screw fixation with posterolateral fusion and pedicle screw fixation with cage posterolateral interbody fusion in adult spondylolithesis except correction degree of anterior slippage.