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Lumbar fusion for lytic spondylolisthesis: Is an interbody cage mandatory?

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Lumbar fusion for lytic spondylolisthesis: Is an interbody cage mandatory?

J Craniovertebr Junction Backbone. 2018 Apr-Jun;9(2):101-106

Authors: Boktor J, Ninan T, Pockett R, Collins I, Sultan A, Koptan W

Summary
Research Design: This research was a retrospective observational research.
Objective: The aim of the research was to find out the radiological and scientific end result of utilizing regionally sourced autologous bone graft within the surgical administration of single-level lumbar lytic spondylolisthesis.
Background: Many spinal surgeons complement pedicle screw fixation of lumbar spondylolisthesis with cages. In creating international locations, the excessive value of interbody cages has precluded their use, with surgeons resorting to filling the interbody house with various kinds of bone graft as a substitute. This research reviews on the scientific and radiological end result of posterior lumbar interbody fusions for low-grade lytic spondylolisthesis utilizing regionally sourced autologous bone graft.
Materials and Strategies: Posterior interbody fusion was carried out in 22 consecutive sufferers over 18-month interval, utilizing (BRAND) pedicle screw system and regionally sourced bone graft, i.e., bone eliminated throughout neural decompression. There have been no postoperative restrictions, and all sufferers underwent scientific end result measurements utilizing Oswestry Incapacity Index (ODI), visible analogue ache rating (VAS) at a minimal follow-up of 12 months, and computed tomography (CT) evaluation of fusion with intraobserver validation by radiology guide blinded, at 6 and12 months. Almost 50% of the inhabitants have been people who smoke.
Outcomes: There was vital scientific enchancment in ODI, VAS again ache, and VAS leg ache (P < zero.001). Against this, the radiologic fusion fee measured by CT at 12 months was much less passable at 64%. There was no distinction in scientific end result between the fused group and nonfused inhabitants.
Conclusions: These outcomes point out that using regionally sourced bone graft in single-level lumbar lytic low-grade spondylolisthesis. Interbody fusion supplies good scientific outcomes. Using an interbody cage is probably not clinically mandatory. Our radiologic end result, nonetheless, exhibits inferior fusion charges in contrast with revealed information. Future analysis will concentrate on long-term outcomes.

PMID: 30008528 [PubMed]

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