Slippage reduction of lumbar spondylolisthesis using percutaneous pedicle screw with reduction fixation system after interbody fusion: A comparison with traditional open fusion and pedicle screw fixation.
Reduction of the slipped vertebra as a part of surgical approach is still debatable. The author investigated the usefulness of percutaneous reduction fixation system for the treatment of lumbar spondylolisthesis via a comparison with traditional open pedicle screw fixation after posterior decompression and interbody fusion. This study included 65 patients with lumbar spondylolisthesis, who underwent either open transpedicular screw fixation (OTPSF) with posterior lumbar interbody fusion (PLIF) (OTPSF group, n = 33) or PPSF with reduction system (PPSFr group, n = 32) after PLIF. The slippage degree (SD); the intervertebral disc height (IDH); lumbar lordosis (LL); and segmental angle (SA) were measured on the follow-up simple lateral radiographs. For pain and functional assessment in patients, visual analogue scale (VAS) scores for low back pain and leg pain, and Oswestry Disability Index (ODI) scores were measured. SA (P < 0.05) and LL (P < 0.05) were significantly improved and well maintained in the PPSFr group compared to the OTPSF group. Reduction of SD was significantly greater in the PPSFr group than the OTPSF group (P < 0.05). Although there were no significant differences in VAS scores for back pain and radiculopathy between the two groups during the follow-up, the final ODI score was significantly lower in the PPSFr group than the OTPSF group (P < 0.05). PPSFr combined with PLIF showed superior clinical and radiological outcomes compared to traditional OTPSF with PLIF in the treatment of lumbar spondylolisthesis. This study showed that reduction of the SD was important factors for maintaining LL.