The Addition Of Posterior Lumbar Interbody Fusion Using Cage To Pedicle Screw Fixation In The Treatment Of Lumbar Spondylolisthesis

Objective Spondylolisthesis is one of the most important factors that result in low back pain.The etiology and pathogenesis of spondylolisthesis is varied. The optimal procedure for the treatment of spondylolisthesis remains controversial. The purpose of this study was to evaluate the value of adding posterior lumbar interbody fusion using cage to pedicle screw fixation in the treatment of low grade ( I / II )lumbar spondylolisthesis. Methods From 1998 to 2002,26 consecutive adult patients (female 10,male 16) underwent surgical treatment with pedicle screw fixation and posterior lumbar interbody fusion using cage. Clinical outcomes were assessed by the Japanese Orthopaedic Association(JOA)score. Radiographic results including disc high, Index of lumbar spinal curvature,slip%,full lumbar lordosis and segmental lumbar lordosis were measured. Results 26 patients were followed up for an average of 18 months (range, 6-48 months) after operation. Significant improvements of JOA score and lumbar sagittal profile were observed. Conclusion Fusion after decompression is critical in order to achieve clinical success in the majority of spondylolistic patients .Improvement of symptom, high fusion rate,restoration and maintain of disc space and normal lumbar lordosis could been achieved by using posterior lumbar interbody fusion with cage and pedicle screw fixation. Posterior lumbar interbody fusion using diagonal insertion of a single threaded cage after total discectomy was a safe and effective method.