Pedicle screw shift without loosening following instrumented posterior fusion: limitations of pedicle screw fixation

This study aimed to assess pedicle screw (PS) shift without loosening to identify the mechanism of the change in disc angle after posterior fusion for degenerative lumbar spondylolisthesis (DLS). Sixty-three consecutive patients who underwent facet fusion for L4 single-level DLS were retrospectively reviewed using computed tomography (CT) immediately after surgery and 6 months postoperatively. Twenty-two patients (88 PSs) in whom the disc angle had decreased by more than 4° at 6-month postoperative radiographic follow-up were selected to more readily identify and quantif y PS shift. Six patients with PS loosening and/or nonunion were excluded. We reconstructed a CT plane, vertical to the cranial endplate of the vertebrae and passing through the cannula used for percutaneous PSs. Angle α, which is formed by the cranial endplate and the cannula on this plane, was mea sured. A change in angle α of more than 2° between the immediate postoperative period and the 6-month follow-up was defined as a PS shift. Angle α did not change by more than 2° in any of the 44 PSs in the upper vertebrae of the fused segment. In the lower vertebrae, angle α changed by more tha n 2° in 22 of 44 PSs. The change in angle α in the lower vertebrae (average, 2.3°) was significantly greater than that in the upper vertebrae (average, 0.2°) (P 
Source: Neurosurgical Review - Category: Neurosurgery Source Type: research

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ConclusionsEnhanced strut porosity SiCaP EP provided high (month 12: 86.3%) spinal fusion success rates in PLF surgery. Fusion success was associated with improved clinical outcomes in patients within 12  months, relative to baseline.ClinicalTrials.gov identifierNCT01452022Graphical abstractThese slides can be retrieved under Electronic Supplementary Material.
Source: European Spine Journal - Category: Orthopaedics Source Type: research
Authors: Abstract OBJECTIVEThe pedicle screw-based Dynesys dynamic stabilization (DDS) has reportedly become a surgical option for lumbar spondylosis and spondylolisthesis. However, it is still unclear whether the dynamic construct remains mobile or eventually fuses. The aim of this study was to investigate the incidence of unintended facet arthrodesis after DDS and its association with spondylolisthesis.METHODSThis retrospective study was designed to review 105 consecutive patients with 1- or 2-level lumbar spondylosis who were treated with DDS surgery. The patients were then divided into 2 groups according to p...
Source: Journal of Neurosurgery.Spine - Category: Neurosurgery Tags: J Neurosurg Spine Source Type: research
J Neurol Surg A Cent Eur Neurosurg DOI: 10.1055/s-0038-1655760 Background Lumbar spinal stenosis (LSS) and low-grade degenerative spondylolisthesis are frequently associated with facet joint degeneration, considered the main cause of low back pain. Surgery is the treatment of choice in patients affected by LSS unresponsive to conservative treatment. The aim of this study was to evaluate the clinical and radiologic outcome of patients treated with posterior decompression and transfacet fixation for single-level LSS and facet joint degeneration. Methods A total of 25 patients between May 2015 and June 2016 af...
Source: Journal of Neurological Surgery Part A: Central European Neurosurgery - Category: Neurosurgery Authors: Tags: Original Article Source Type: research
Study Design: A retrospective study. Objective: To determine the clinical and radiologic outcomes of the long-term results of instrumented minimally invasive spinal-transforaminal lumbar interbody fusion (MIS-TLIF) in unstable, single-level, low-grade, isthmic spondylolisthesis (IS) or degenerative spondylosis (DS) including degenerative spondylolisthesis, foraminal stenosis with central stenosis, degenerative disk disease, and recurrent disk herniation. Summary of Background Data: MIS-TLIF is a common surgical procedure to treat lumbar spondylolisthesis. However, there are no studies that have documented the long-...
Source: Journal of Spinal Disorders and Techniques - Category: Surgery Tags: Primary Research Source Type: research
CONCLUSIONS Treatment of patients with symptomatic LSS with a PLO procedure provided substantial enlargement of the area of the spinal canal and favorable clinical results for both disease-specific and non-disease-specific outcome measures at all follow-up time points out to 5 years. Future research is needed to compare this technique to alternative therapies for LSS. PMID: 29856305 [PubMed - as supplied by publisher]
Source: Journal of Neurosurgery.Spine - Category: Neurosurgery Authors: Tags: J Neurosurg Spine Source Type: research
ConclusionThe study showed that the extreme lateral approach to the lumbar spine in case of isthmic spondylolisthesis is a reliable and safe option to the most common open procedures. In the authors ’ opinion, XLIF procedures allow a good correction of the listhesis associated with good clinical and radiographic results.Graphical abstractThese slides can be retrieved under Electronic supplementary material.
Source: European Spine Journal - Category: Orthopaedics Source Type: research
Authors: Debnath UK, Chatterjee A, McConnell JR, Jha DK, Chakraburtty T Abstract STUDY DESIGN: Prospective nonrandomized study. PURPOSE: To find a possible correlation between clinical outcome and extent of lumbar spondylolisthesis reduction. OVERVIEW OF LITERATURE: There is no consensus in the literature concerning whether a beneficial effect of reduction on outcome can be expected following reduction and surgical fusion for low grade lumbar spondylolisthesis. METHODS: Forty six patients with a mean age of 37.5 years (age, 17-48 years) with isthmic spondylolisthesis underwent interbody fusion with cage...
Source: Asian Spine Journal - Category: Orthopaedics Tags: Asian Spine J Source Type: research
Study Design. A retrospective study to evaluate the clinical outcomes of a novel surgical method for treating patients with lumbar spondylolysis. Objective. The aim of this study was to investigate the effectiveness of posterior ISOBAR TTL stabilization of the lumbar spine with direct pars repair using Wiltse approach for the treatment of lumbar spondylolysis with or without slight spondylolisthesis and discuss the indications of this surgery. Summary of Background Data. Surgical treatment of lumbar spondylolysis has yielded relatively good results. However, there are still many limitations of the current surgical method...
Source: Spine - Category: Orthopaedics Tags: Surgery Source Type: research
This study aimed to compare the outcomes of Dynesys dynamic stabilization (DDS) with minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) for the management of single-level spondylolisthesis at L4-5. METHODS This study retrospectively reviewed 91 consecutive patients with Meyerding Grade I spondylolisthesis at L4-5 who were managed with surgery. Patients were divided into 2 groups: DDS and MI-TLIF. The DDS group was composed of patients who underwent standard laminectomy and the DDS system. The MI-TLIF group was composed of patients who underwent MI-TLIF. Clinical outcomes were evaluated by visual analog sca...
Source: Neurosurgical Focus - Category: Neurosurgery Authors: Tags: Neurosurg Focus Source Type: research
Conclusion. FF achieved good clinical outcomes that were superior to those of conventional PLF with a comparable fusion rate. It is useful for managing DLS and is a minimally invasive evolution of PLF. Level of Evidence: 3
Source: Spine - Category: Orthopaedics Tags: Surgery Source Type: research
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