This study aims to evaluate clinical and radiological outcomes of isthmic spondylolisthesis surgically treated with combined approach. The goal is to demonstrate that it is a safe and efficient technique to treat isthmic spondylolisthesis. There is very little literature concerning this procedure.
Isthmic spondylolisthesis can cause back and leg pain. If pain persists after well conducted medical management, a surgical treatment can be proposed. Even though the goal is consensual, there are plenty of ways to reach vertebral fusion: ALIF, PLIF, TLIF, Posterior fusion only, etc… This study aims to evaluate clinical and radiological outcomes of isthmic spondylolisthesis surgically treated with combined approach. The goal is to demonstrate that it is a safe and efficient technique to treat isthmic spondylolisthesis using standard XRays, CT Scan and patient reported outcome measurements. There is very little literature concerning this procedure.
Study Type
OBSERVATIONAL
Enrollment
87
First in supine position, an ALIF is performed: with a Pfannenstiel incision, through a retroperitoneal approach, a discectomy is performed at the level of the spondylolisthesis then a cage is placed between the two vertebral bodies. Then, in prone position, a standard posterior approach is performed, pedicle screws are placed to achieve a postero-lateral fusion. A decompression may be associated.
CMC Ambroise Pare
Neuilly-sur-Seine, Île-de-France Region, France
Fusion status
Every patient has a CT-Scan of the lumbar spine done to check fusion status. The interpretation is made by the surgeon who did the surgery and one independent reviewer.
Time frame: From 6 months to 1 year after surgery
Restoration of the foraminal diameter
The foraminal diameter is measured to quantify the restoration of the foraminal diameter after surgery, making more room for the nerve root.
Time frame: 3 months and 1 year after surgery
Correction of the spondylolisthesis-induced kyphosis after surgery
The lumbo-sacral angle is measured to quantify the correction of the spondylolisthesis-induced kyphosis after surgery.
Time frame: 3 months and 1 year after surgery
Segmental lordosis
Segmental lordosis is measured with the L5-S1 lordosis, quantifying the correction at the spondylolisthesis level
Time frame: 3 months and 1 year after surgery
Local Lordosis
Local Lordosis measured with the L4-S1 lordosis, quantifying the correction in the lower lumbar region
Time frame: 3 months and 1 year after surgery
Back pain
Measured with Lumbar Visual Analogic Scale. The patient quantifies his back pain with a number, ranging from 0 to 10 (0 = no pain, 10= worst possible pain)
Time frame: Pre-operative, 3 months and 1 year after surgery
Sciatica
Measured with Radicular Visual Analogic Scale. The patient quantifies his leg pain with a number, ranging from 0 to 10 (0 = no pain, 10= worst possible pain)
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Time frame: Pre-operative, 3 months and 1 year after surgery
Disability
Measured with the ODI (Oswestry Disability Index). The patient answers 10 questions concerning his daily life and the disability caused by his back problem, giving a global score. 0 is equated with no disability and 100 is the maximum disability possible.
Time frame: Pre-operative, 3 months and 1 year after surgery
Complication rate
intra-operative, early and late post-operative complications (vascular injury, non-union, infection, etc…)
Time frame: until 1 year after surgery