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Multilevel Spondylolysis Restore Utilizing the “Smiley Face” Approach with Three-Dimensional Intraoperative Spinal Navigation.

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Multilevel Spondylolysis Restore Utilizing the “Smiley Face” Approach with Three-Dimensional Intraoperative Spinal Navigation.

World Neurosurg. 2018 Jan;109:e609-e614

Authors: Voisin MR, Witiw CD, Deorajh R, Guha D, Oremakinde A, Wang S, Yang V

Summary
BACKGROUND/OBJECTIVE: Multilevel spondylolysis is a uncommon explanation for progressive decrease again ache, and sufferers who fail conservative administration are handled surgically. Direct restore strategies can preserve mobility and result in decreased morbidity in contrast with spinal fusion in single-level spondylolysis. On this paper, we current a affected person with nonadjacent multilevel spondylolysis who underwent the “smiley face” strategy of direct multilevel restore with out fusion utilizing three-dimensional intraoperative spinal navigation.
METHODS: Bilateral spondylolysis at L3 and L5 with related spondylolisthesis in a 50-year-old male was repaired utilizing the “smiley face” method. Affected person-reported outcomes, together with the Oswestry Incapacity Index (ODI) and visible analog scale scores for again and leg ache, had been assessed preoperatively together with 6 weeks and four months postoperatively.
RESULTS: Postoperative computed tomography imaging confirmed exact screw insertion and rod placement together with secure alignment in follow-up imaging. The affected person’s ODI and decrease again visible analog scale scores decreased from 25 to eight and seven.5 to four, respectively, correlating to a wonderful end result on ODI.
CONCLUSION: Direct restore and avoidance of fusion is feasible and may present good useful outcomes in sufferers with nonadjacent multilevel spondylolysis and related spondylolisthesis.

PMID: 29054782 [PubMed – indexed for MEDLINE]

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