Iatrogenic Spondylolisthesis Following Open Lumbar Laminectomy: Case Collection and Evaluation of the Literature.
World Neurosurg. 2018 Feb 14;:
Authors: Ramhmdani S, Xia Y, Xu R, Kosztowski T, Sciubba D, Witham T, Bydon A
OBJECTIVE: The prognosis and surgical administration of post-laminectomy spondylolisthesis in sufferers with out pre-operative instability is introduced with a evaluate of related literature.
METHODS: We reviewed the medical information and radiographic research of 105 sufferers who underwent first-time bilateral 1-Four stage open laminectomies for degenerative lumbar illness at a single tutorial establishment. Sufferers who initially introduced with listhesis and had further discectomy or fusion procedures had been excluded.
RESULTS: In 105 sufferers with laminectomies throughout 1-Four ranges, 10 sufferers (9.5%) developed subsequent iatrogenic spondylolisthesis on the identical operative ranges that required reoperation; 5 males and 5 girls with a median age of 63.zero ± 11.2 years. New or worsening low again ache and decrease extremity ache had been reported over a median interval of 19.zero ± 17.5 months post-operatively. Imaging research confirmed new spondylolisthesis that was not current previous to the index surgical procedure. The commonest ranges had been L4-L5. All sufferers had been handled surgically with posterior instrumented fusion. The common interval between the primary and second surgical procedure was 32.6 ± 19.9 months. Surgical discount of spondylolisthesis resulted in vital scientific enchancment of the sufferers’ signs.
CONCLUSIONS: In sufferers with out overt pre-existing instability, laminectomy for lumbar stenosis can disrupt spinal stability and lead to iatrogenic spondylolisthesis. The extent of decompression of the aspect joints, variety of ranges decompressed, and pre-operative disc area peak might help assess the chance of post-operative spondylolisthesis. Sufferers who develop recurrent radiculopathy after decompressive lumbar laminectomy must be evaluated for potential iatrogenic spondylolisthesis.
PMID: 29454126 [PubMed – as supplied by publisher]