Türk Nöroşirürji Dergisi 1998 , Vol 8 , Num 1
SURGICAL TREATMENT OF DEGENERATIVE SPONDYLOLISTHESIS
Said NADERİ1, Serdar ÖZGEN1, Selim YALÇIN2, Osman GÜVEN2, Necmettin PAMİR1
1Marmara Üniversitesi Tıp Fakültesi Nörşirürji Anabilim Dalı ve Marmara Üniversitesi Nörolojik Bilimler Enstitüsü, İstanbul
2Marmara Üniversitesi Tıp Fakültesi Ortopedi ve Travmatoloji Anabilim Dalı, İstanbul
One of the most important causes of spinal segmental instability is lumbosacral spondylolisthesis. Twenty one consecutive patients with degenerative spondylolisthesis who had surgical treatment are presented. Radiologic examination demonstrated grade I spondylolisthesis in 85.75 %, and grade II spondylolisthesis in 14.7 % of the patients. Spondylolisthesis was detected at L4-5 segment in 61.9 %, at L3-4 in 14.3 %, at L5-S1 in 9.5%, and in multiple segments in 14.3 % of the patients. A decompressive laminectomy was performed in 85.7 % of patients, and transpedicular fixation and posterolateral fusion was performed in all. A comparison of pre- and postoperative radiological investigations revealed a significant decrease in percent-slip (p<0.05). Postoperative clinical assessment showed an excellent clinical outcome in 52.3 %, a good outcome in 42.8 %, and a fair outcome in 4.7 % of the patients. A 90.4 % fusion rate was achieved after a 14.4 months of mean follow-up period. On the basis of our clinical and radiological results it cart be concluded that internal fixation and posterolateral fusion are effective and safe methods in the treatment of degenerative lumbosacral spondylolisthesis, providing high spinal fusion rate. Anahtar Kelimeler : Degenerative lumbosacral spondylolisthesis, fusion, transpedicular fixation