Original Article

COMPARISON BETWEEN THE PRE- AND POSTOPERATIVE RADIOLOGICAL FINDINGS AND CLINICAL OUTCOMES EVALUATION OF THE PATIENTS WHO UNDERWENT SURGERY FOR LUMBAR SPONDYLOLISTHESIS

  • Meliha GÜNDAĞ PAPAKER
  • Erhan EMEL
  • Anas ABDALLAH
  • M. Hakan SEYİTHANOĞLU
  • Tolga Turan DÜNDAR
  • Serkan KİTİŞ

Received Date: 03.01.2018 Accepted Date: 04.03.2018 J Turk Spinal Surg 2018;29(2):97-102

Aim:

We aimed to evaluate the surgical outcomes in the patients who underwent surgery for lumber spondylolisthesis by evaluation pre- and postoperative clinical results, radiological fusion and adjacent segment disease rates.

Material and Methods:

Pre- and postoperative clinical evaluations using pre- and postoperative Visual Analog Scale (VAS) were performed in 48 patients who operated on for Grade 1, 2 and 3 spondylolisthesis. Radiological evaluation was retrospectively performed using direct radiographs, three-dimensional lumbar tomography (CT), and lumbar magnetic resonance imaging (MRI). The presence of pars defect, the presence of instability, Meyerding slip rate, slip percentage, slip angle, sacral slope (angle of inclination), sagittal range of motion, sacrohorizontal angle (pelvic tilt), and lumber lordosis angle were measured on direct radiographs. Dynamic radiographs and Lumbar CT were used for fusion detection. Lumber MRI was used to assess adjacent segment degeneration.

Results:

48 (43 female and 5 male) spondylolisthesis patients were operated on, with a mean age of 49.1 years and an average follow-up of 4.5 years. There was a significant decrease in postoperative back VAS (p = 0.01), and leg VAS (p = 0.02) values of the cases. The mean slippage percentage of the cases was 19.2 % in the preoperative period versus 13.2 % in the postoperative period. The mean slip angle was 10.180 in the preoperative period versus 6.640 in the postoperative period. The mean lumbar lordosis angle was 34.170 in the preoperative period versus 32.510 in the postoperative period. The mean sacral slope was 45.820 in the preoperative period versus 44.590 in the postoperative period.

Conclusion:

Good clinical outcomes can be obtained with posterior instrumentation and fusion in the long-term instability patients.

Keywords: Spondylolisthesis, fusion, lumbar lordosis, sacral inclination