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Neurochirurgie. 2017 May;63(2):74-80. doi: 10.1016/j.neuchi.2017.01.005. Epub 2017 May 13.

[A continuous series of 27 adult patients treated for L5-S1 isthmic spondylolisthesis by combined approach: Clinical and radiological outcomes at 1 year follow-up].

[Article in French]

Author information

1
Département de neurochirurgie et chirurgie du rachis, hôpital P.-Wertheimer, hospices civils de Lyon, université Claude-Bernard Lyon-1, 59, boulevard Pinel, 69003 Lyon, France. Electronic address: colo10fr@hotmail.com.
2
Département de neurochirurgie et chirurgie du rachis, hôpital P.-Wertheimer, hospices civils de Lyon, université Claude-Bernard Lyon-1, 59, boulevard Pinel, 69003 Lyon, France.
3
Laboratoire d'épidémiologie, recherche clinique et santé communautaire, faculté de médecine et de pharmacie, CHU Hassan II, Km 2.200 route de Sidi-Harazem, 1893 Fès, Maroc.
4
Hôpital de l'Amitié Sino-Guinéenne, Hasigui Kipé-Ratoma 030, 710 Conakry, Guinée.
5
Département de neurochirurgie et chirurgie du rachis, hôpital P.-Wertheimer, hospices civils de Lyon, université Claude-Bernard Lyon-1, 59, boulevard Pinel, 69003 Lyon, France; Institut de biomécanique humaine Georges-Charpak, arts et métiers ParisTech, Ensam, 151, boulevard de l'Hôpital, 75013 Paris, France.

Abstract

Through this single-center consecutive prospective study, we evaluated the results of a combined approach for L5-S1 isthmic spondylolisthesis, using a polyetheretherketone (PEEK) interbody lordotic cage during anterior approach and pedicle screw-based posterior fixation. Between 2010 and 2014, 27 adult patients were treated for L5-S1 isthmic spondylolisthesis (high and low grades) by a combined approach with a minimum follow-up of one year. Clinical outcome was assessed before surgical treatment and at four months and one year after surgery by: VAS, Oswestry Index (ODI) and Rolland-Morris scores. Two observers evaluated the following radiological parameters: pelvic incidence, pelvic tilt, lumbar lordosis, segmental lordosis L5-S1, anterior and posterior disc height, spinal vertical axis (SVA), SVA/sacro-femoral distance (SFD) ratio. Fusion was evaluated on the CT scan at one-year follow-up. Blood loss, surgery time and complications were also collected. The mean age was 47.7 years (±16.9). The VAS, ODI and Rolland-Morris scores were significantly improved postoperatively, decreased from 7.5 (±1.45); 48 (±19.25); 15.3 (±4.67) before the surgery to 3.8 (±2.55); 28.7 (±19.58) and 7.76 (±7.21) respectively at one year after the surgery (P=0.05). The mean follow-up was 3.3 years. Mean surgery time was 193.7min (±37). Fusion was obtained in 100% of cases. Segmental lordosis L5-S1, pelvic tilt, slippage, anterior and posterior L5-S1 disc height were significantly improved postoperatively, they passed from 20.1; 22.6; 35.3%; 26.4%; 17.9% to 29.5; 20.6; 20.3%; 64.4%; 36.3% respectively. Combined surgical procedure meets the required goals of surgery in the treatment of adults L5-S1 isthmic spondylolisthesis.

KEYWORDS:

Arthrodèse vert,brale; Combined approach; Lordose lombaire; Lordosis; Neurosurgical procedures; Sagittal balance; Spinal fusion; Spondylolisth,sis; Spondylolisthesis; Technique neurochirurgicale; Voie combinée; Équilibre sagittal

PMID:
28511802
DOI:
10.1016/j.neuchi.2017.01.005
[Indexed for MEDLINE]

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