Comparison between Posterolateral Fusion with Pedicle Screw Fixation and Anterior Interbody Fusion with Pedicle Screw Fixation in Spondylolytic Spondylolisthesis of the Lumbar Spine

Suk, Kyung Soo; Jeon, Chang Hoon; Lee, Hwan Mo; Kim, Nam Hyun; Kim, Hyung Chan

Abstract

STUDY DESIGN: A retrospective study was performed in spondylolytic spondylolisthesis patients who had undergone posterolateral fusion with pedicle screw fixation or anterior lumbar interbody fusion with pedicle screw fixation.
OBJECTIVES
To compare the clinical outcomes of posterolateral fusion with pedicle screw fixation and anterior lumbar interbody fusion with pedicle screw fixation, and to help in the selection of treatment options. SUMMARY OF LITERATURE REVIEW: There have been many reports regarding 360degree fusion, anterior lumbar interbody fusion, posterolateral fusion, and posterior lumbar interbody fusion with or without instrumentation in spondylolytic spondylolisthesis. However, there has been no reports regarding the comparison between posterolateral fusion with pedicle screw fixation and anterior lumbar interbody fusion with pedicle screw fixation.
MATERIALS AND METHODS
Fifty-six patients with spondylolytic spondylolisthesis who underwent posterolateral fusion with pedicle screw fixation(group 1, 35 patients) or who underwent anterior lumbar interbody fusion with pedicle screw fixation(group 2, 21 patients) were studied. Minimum follow-up was 2 years. Demographic variables and disease state were similar between the two groups. We reviewed medical records and radiological films. We studied operating time, amount of blood loss, duration of hospital stay, clinical outcomes, complications, time at which fusion was complete, fusion rate, and radiological measurements.
RESULTS
There were no significant differences between the two groups in terms of amount of blood loss, duration of hospital stay, back pain, radiating pain, fusion rate, and complication rate. However, in the group of anterior interbody fusion with pedicle screw fixation, the operation time and the time at which fusion was complete was longer. There was significant radiological reduction loss in group 1.
CONCLUSIONS
Posterolateral fusion with pedicle screw fixation was just as effective as anterior interbody fusion with pedicle screw fixation in terms of clinical outcomes, but anterior lumbar interbody fusion with pedicle screw fixation was superior to posterolateral fusion with pedicle screw fixation in terms of prevention of reduction loss. Anterior support would be helpful for the prevention of reduction loss in spondylolytic spondylolisthesis of the lumbar spine.