spine, spinal fixation, listhesis

Degenerative spine disorders are very common in the aging population. Degenerative spondylolisthesis is a relatively uncommon cause of chronic back pain in these patients. We present a case of high-grade spondylolisthesis managed with posterior lumbar interbody fusion (PLIF) and reduction of the listhesis with excellent results. A 56-year-old woman presented with chronic lower back pain managed as an outpatient for over 5 months with no relief. She had no history of trauma or risk factors for malignancy. Lumbosacral CT showed Meyerding grade 3 anterolisthesis of the fifth lumbar vertebra with complete L5-S1 disc collapse and bilateral spondylolysis...

OBJECTIVE: The object of this study was to compare, after a long-term follow-up, the incidence and features of adjacent segment disease (ASDis) following lumbar fusion surgery performed via an open technique using conventional interbody fusion plus transpedicular screw fixation or a minimally invasive surgery (MIS) using a tubular retractor together with percutaneous pedicle screw fixation. METHODS: The authors conducted a retrospective chart review of patients with a follow-up period > 10 years who had undergone instrumented lumbar fusion at the L4-5 level between January 2004 and December 2010...

Pediatric spinal trauma can present a surgeon with difficult management decisions given the rarity of these cases, pediatric anatomy, and a growing spine. The need to stabilize a traumatically unstable pediatric spine can be an operative challenge given the lack of instrumentation available. The authors present a surgical technique and an illustrative case that may offer a novel, less disruptive method of stabilization. A 2-year-old girl presented after an assault with an L1-2 fracture subluxation with lateral listhesis and fractured jumped facets exhibited on CT scans...

INTRODUCTION: Spinal tuberculosis (TB) is a common infectious disease prevalent in developing countries and an increasing issue in developed countries. The association of tuberculosis with spondylolisthesis is rarely reported in literature. The aim of our review is to analyze the clinical features and radiologic characteristics of TB spondylolisthesis and to provide a concise update on its surgical management, based on the literature. METHODS: A systematic review was performed after conducting a thorough search of the PubMed database...

BACKGROUND: Pedicle screw fixation in high grade lumbar listhetic vertebral body has been nightmare for Orthopaedic and spine surgeons. This is because of abnormally positioned listhetic pedicles and non-visualization of pedicle in conventional image intensifier (C-Arm). This results into increased surgical time, more blood loss, radiation exposure and more chances of infection. To overcome this problem, we have devised a new Technique of putting of pedicle screw fixation in listhetic vertebrae...

INTRODUCTION: We investigated Medicare diagnosis-related group (DRG)-based reimbursement for minimally invasive surgery (MIS) deformity procedures in our study group hospitals based on length of stay and presence of comorbid conditions (CC). METHODS: DRG-based reimbursement was obtained for MIS anterior, posterior, and circumferential 1-level and multilevel fusion for listhesis and deformity cases with and without CC from 12 institutions throughout the United States...

BACKGROUND: Pedicle fractures in the cervical spine are common. They may occur in isolation or in combination with other concomitant fractures. Multiple classification systems have been introduced to provide a clinical framework when approaching these types of fractures; however, these systems do not provide guidelines for optimal treatment. Data regarding decision making are limited. Conservative treatment with orthoses may result in subluxation and instability requiring further treatment...

BACKGROUND CONTEXT: Anterior lumbar interbody fusion (ALIF) with percutaneous pedicle screw fixation (PPF) provides successful surgical outcomes to isthmic spondylolisthesis patients with indirect decompression through foraminal volume expansion. However, indirect decompression through ALIF followed by PPF may not obtain a successful surgical outcome in patients with isthmic spondylolisthesis accompanied by foraminal stenosis caused by a posterior osteophyte or foraminal sequestrated disc herniation...

PURPOSE: To report the results of a cohort of patients treated with this technique high lighting radiological and functional outcomes, discussing also benefits arising from a gradual reduction procedure compared with other techniques. METHODS: We evaluated nine patients who have undergone high-grade listhesis reduction and circumferential fusion at our institution from 1988 to 2006. Average length of follow-up was 11 years (5-19). Functional outcomes and radiological measurements were recorded and reported...

BACKGROUND: Instrumented circumferential fusion has been used as a primary and salvage procedure in lumbar spine fusion, especially for adult low-grade isthmic spondylolisthesis. Recently, instrumented anterior lumbar interbody fusion (ALIF) has been shown to provide good clinical and radiologic results that are comparable with those attained with traditional lumbar fusion. However, there have been no reports available that compare instrumented circumferential fusion with instrumented ALIF...

The management of spinal tuberculosis, especially in children, is controversial. In children, vertebral destruction is more severe than adults because of the cartilaginous nature of their bone. Modern chemotherapy has significantly decreased mortality in spinal tuberculosis, but morbidity remains high. Without early surgery, patients can develop severe kyphosis leading to respiratory insufficiency, painful costopelvic impingement and paraplegia. Lumbar kyphosis results in early degenerative lumbar canal stenosis and is cosmetically unacceptable...

BACKGROUND: Reduction of severe spondylolisthesis is controversial. Publications have emphasized the techniques of reduction and associated complications, but there is little knowledge about the effect of reduction on the sagittal balance of the spine and pelvis in the postoperative patient. This study evaluated the effect of surgical reduction and instrumented fusion of spondylolisthesis on the pelvic anatomy and spinopelvic sagittal balance. METHODS: This is a retrospective study of 26 adolescents (mean age, 13...

The association between scoliosis and spondylolisthesis is well documented; however, spondylolisthesis following a posterior spinal fusion with Harrington rod instrumentation for idiopathic scoliosis has not been previously reported. Internal fixation of the spine with metal rods and fusion for scoliosis produces a stress concentration at the immediately adjacent levels. This, combined with other factors that may cause failure of the neural arch, can lead to a traumatic spondylolisthesis. In an 11-year-old boy, localized pain and impending listhesis indicated that the instrumentation should be removed and an arthrodesis completed...

Traumatic rotatory displacement (TRD) are defined as all slight anterior corporeal displacements (less than 1/3 of the vertebral body) secondary to different vectors, but with a constant and dominant rotatory component. The authors report on 47 cases of TRD (35% of all severe lower cervical spine injuries) (follow-up: 6 months to 7 years). TRD occurs only when two lesions are present: an anterior lesion in the disk and ligaments, and a posterior lesion of the articular process, as the authors confirmed earlier in an experimental study on monkeys and specimens...