Results of in situ fusion for isthmic spondylolisthesis

Lawrence G. Lenke, Keith H. Bridwell, David Bullis, Randal R. Betz, Christy Baldus, Perry L. Schoenecker

Research output: Contribution to journalArticlepeer-review

256 Scopus citations

Abstract

Between 1976 and 1990, we treated 56 isthmic spondylolisthesis patients with an average age of 15 + 4 (range, 4 + 9 to 27 ± 2) with in situ bilateral transverse process fusions utilizing autogenous iliac bone graft. None of the patients had a decompression or instrumentation placed. Radiographic fusion was determined from standing spot lateral radiographs and either Ferguson AP or standing AP views of the lumbosacral junction. The radiographic fusion patterns were categorized into the following four grades: (A) definitely solid (n = 28, 50%)—solid big trabeculated bilateral fusion masses; (B) possibly solid (n = 10, 18%)—unilateral large fusion mass with contralateral small fusion mass; (C) probably not solid (n = 6, 11%)—small, thin fusion masses bilaterally; (D) definitely not solid (n = 12, 21%)—graft resorption bilaterally or fusion mass with obvious bilateral pseudarthrosis. This fusion pattern is best determined by the Ferguson (“true AP”) radiograph of the lumbosacral junction. Despite this surprisingly low fusion rate, overall clinical improvement was noted in >80% of patients with preoperative symptoms of back pain, leg pain, or hamstring tightness. We recommend this critical assessment of fusion grades to determine fusion success in this patient population.

Original languageEnglish
Pages (from-to)433-442
Number of pages10
JournalJournal of Spinal Disorders
Volume5
Issue number4
DOIs
StatePublished - Dec 1992

Keywords

  • In situ arthrodesis
  • Isthmic spondylolisthesis

Fingerprint

Dive into the research topics of 'Results of in situ fusion for isthmic spondylolisthesis'. Together they form a unique fingerprint.

Cite this