A novel technique for stabilization of high-grade spondylolisthesis with transvertebral fusion without reduction

Publication date: Available online 22 November 2018Source: Journal of Clinical NeuroscienceAuthor(s): Chester J. Donnally, Karthik Madhavan, Alexander J. Butler, Jonathan I. Sheu, Dustin H. Massel, Barth A. Green, Joseph P. GjolajAbstractSurgical treatment of high-grade spondylolisthesis and spondyloptosis is recommended in symptomatic patients, yet there exists much debate regarding the optimal surgical approach and the need for reduction. Similar to the Bohlman technique in that fixation is achieved across two vertebral endplates, we discuss a novel technique with the advantage of using bilateral threaded pedicle screws of large diameter and length instead of a single fibula allograft. Patients underwent posterior instrumented fusion without spondylolisthesis reduction using a novel technique placing pedicle screws with a transvertebral trajectory through the two end plates involved in the spondylolisthesis. Following screw placement, patients underwent decompression ± discectomy. Screws were connected to adjacent pedicle screws either in the upper adjacent vertebrae (i.e. L5) or the more rostral adjacent vertebrae (i.e. L4) if spinal alignment or instability necessitate including additional levels of fixation. Three patients were reviewed with ages of 67, 62, 58 years, operative times of 377–790 min, estimated blood loss 400–1050 cc, and follow-up times of 478–1082 days. There were no CSF leaks, intragenic neurologic deficits post-operatively, implant fa...
Source: Journal of Clinical Neuroscience - Category: Neuroscience Source Type: research