Interbody fusion and transpedicular fixation in the treatment of spondylolisthesis.

BACKGROUND This is a retrospective analysis of long-term results of treatment of dysplastic, isthmic and degenerative spondylolisthesis with interbody fusion and transpedicular screw fixation. MATERIAL AND METHODS Twenty-one patients underwent interbody fusion with the "Bialstab" transpedicular system. Anterior lumbar interbody fusion (ALIF) was subsequently performed in 2 patients. In the remaining patients, posterior lumbar interbody fusion (PLIF) was performed following interbody fusion in the same session. Mean follow up was 22.4 months. Results were evaluated on the basis of a physical examination, the Oswestry questionnaire and the VAS back pain score. Radiologic assessment was based on targeted lateral radiographs to the stabilized segment. RESULTS The post-operative wound healed without complications in all patients. Clinical outcomes at follow-up were rated as good (10), quite good (9) and poor (2). The average Oswestry score was 14 (range 0-30). The mean VAS score at follow-up was 2.9 (range 0-8). Anatomical slip reposition was performed in 2 patients, partial reposition in 11 patients, and 8 patients were treated with in situ fusion. Radiological evaluation revealed fusion in 17 patients. CONCLUSIONS 1. Transpedicular fixation with interbody fusion is an effective technique for the treatment of spondylolisthesis. 2. Partial reposition of spondylolisthesis with neural decompression makes it possible to avoid neurological complications. 3. The "Bialstab" fixation system fulfills the criteria for good transpedicular stabilization.