Transpedicular Fixation for the Alleviation of Neurogenic Claudication and Backache in the Management of Spondylolisthesis
DOI:
https://doi.org/10.36552/pjns.v28i1.949Keywords:
Spondylolisthesis; Transpedicular fixation; Neurogenic claudication; Backache;Abstract
ABSTRACT
Objective: To evaluate the surgical outcome of transpedicular fixation for degenerative spondylolisthesis in terms of alleviation of neurogenic claudication and backache
Materials & Methods: This prospective observational study was carried out at the department of Neurosurgery, Medical Teaching Institute, Bacha Khan Medical Complex, Swabi over a period of two years i.e. from 1st July, 2021 to 30th June, 2023. Patients presenting with backache and neurogenic claudication and having spondylolisthesis on radiological investigations were subjected to transpedicular fixation and evaluated for improvement in symptoms and fusion rate at 6 months follow up.
Results: 60 patients participated in the study. Mean age was 41.42±7.29 years and 63.3% were females. L5-S1 was the most common level involved in 40% of the patients and 50% of the patients had Grade 2 spondylolisthesis. There was significant reduction in mean back-pain score on NRS post-operatively (Pre-op was 6.73±1.94 Vs. post-op was 1.57±1.34, P value = 0.00). The neurogenic claudication reduced from 88.3% Vs. 10% (P value = 0.00). The fusion rate was 90% at 6 month follow up.
Conclusion: Transpedicular fixation for degenerative spondylolisthesis is the most effective procedure in terms of relief of neurogenic claudication and backache.
References
REFERENCES
Gagnet P, Kern K, Andrews K, Elgafy H, Ebraheim N. Spondylolysis and spondylolisthesis: A review of the literature. Journal of Orthopaedics. 2018 Jun 1;15(2):404-7.
Koslosky E, Gendelberg D. Classification in brief: the Meyerding classification system of spondylolisthesis. Clinical orthopaedics and related research. 2020 May;478(5):1125.
Beck AW, Simpson AK. High-grade lumbar spondylolisthesis. Neurosurgery Clinics. 2019 Jul 1;30(3):291-8.
Li N, Scofield J, Mangham P, Cooper J, Sherman W, Kaye AD. Spondylolisthesis. Orthopedic Reviews. 2022;14(3).
Lan Z, Yan J, Yang Y, Xu Q, Jin Q. A review of the main classifications of lumbar spondylolisthesis. World Neurosurgery. 2023 Mar 1;171:94-102.
Chung CC, Shimer AL. Lumbosacral spondylolysis and spondylolisthesis. Clinics in Sports Medicine. 2021 Jul 1;40(3):471-90.
Wiltse LL, Newman PH, Macnab IA. Classification of spondyloisis and spondylolisthesis. Clinical Orthopaedics and Related Research®. 1976 Jun 1;117:23-9.
García-Ramos CL, Valenzuela-González J, Baeza-Álvarez VB, Rosales-Olivarez LM, Alpizar-Aguirre A, Reyes-Sánchez A. Degenerative spondylolisthesis I: general principles. Acta ortopédica mexicana. 2021 Feb 5;34(5):324-8.
Yang MJ, Kim R, Singla A, Samdani AF. Classification of Spondylolisthesis. Spondylolisthesis: Diagnosis, Non-Surgical Management, and Surgical Techniques. 2023 Jun 27:105-19.
Akkawi I, Zmerly H. Degenerative spondylolisthesis: a narrative review. Acta Bio Medica: Atenei Parmensis. 2021;92(6).
Wang YX, Kaplar Z, Deng M, Leung JC. Lumbar degenerative spondylolisthesis epidemiology: a systematic review with a focus on gender-specific and age-specific prevalence. Journal of Orthopaedic Translation. 2017 Oct 1;11:39-52.
Kobayashi H, Endo K, Sawaji Y, Matsuoka Y, Nishimura H, Murata K, Takamatsu T, Suzuki H, Aihara T, Yamamoto K. Global sagittal spinal alignment in patients with degenerative low-grade lumbar spondylolisthesis. Journal of Orthopaedic Surgery. 2019 Nov 12;27(3):2309499019885190.
Mazurek M, Kulesza B, Go??biowska N, Tyzo B, Kura K, Szczepanek D. Factors Predisposing to The Formation of Degenerative Spondylolisthesis—A Narrative Review. Medicina. 2023 Aug 7;59(8):1430.
Evans N, McCarthy M. Management of symptomatic degenerative low-grade lumbar spondylolisthesis. EFORT open reviews. 2018 Dec 16;3(12):620-31.
De C, De C. Impact of Concomitant Spinal Canal Stenosis on Clinical Presentation of Adult Onset Degenerative Lumbar Spondylolisthesis: A Study Combining Clinical and Imaging Spectrum. Cureus. 2021 Nov 13;13(11).
Ferrero E, Guigui P. Current trends in the management of degenerative lumbar spondylolisthesis. EFORT open reviews. 2018 May 21;3(5):192-9.
Taha A, Youssef M. Surgical Results of Posterior Lumbar Interbody Fusion with Transpedicular Fixation in Management of Spondylolisthesis. Open Journal of Modern Neurosurgery. 2019 Nov 7;10(1):146-56.
Moussa AE, Ali MS, Galal M. Outcome of Transpedicular Screw Fixation with Posterior Interbody Fusion in Management of Spondylolysthesis. International Journal of Medical Arts. 2020 Apr 1;2(2):358-64.
Bulut G, Aytar M, Güngör A. Surgical principles in posterior transpedicular screw fixation and fusion for treatment of spondylolisthesis: Retrospective evaluation of 77 cases. Journal of Turkish Spinal Surgery. 2019.
Bernard F, Mazerand E, Gallet C, Troude L, Fuentes S. History of degenerative spondylolisthesis: From anatomical description to surgical management. Neurochirurgie. 2019 Apr 1;65(2-3):75-82.
Ishaq M, Khan M, Ahmed A, Ali G. Surgical Outcome of Transpedicular Fixation for Degenerative Spondylolisthesis in Terms of Relief from Backache. Pakistan Journal Of Neurological Surgery. 2021 Oct 16;25(3):406-13.
Amir S, Ayub S, Shah TW. Results of Lumbar Transpedicular Fixation for Spondycolisthesis, in Terms of Back Pain Relief. Pakistan Journal Of Neurological Surgery. 2022 Jul 17;26(2):263-9.
Singha SK, Hazra SC, Roy SK, Zahiruddin AK, Mollah MA, Ali MI, Awal KA. Evaluation of results of operative treatment of symptomatic Spondylolisthesis. The Journal of Bangladesh Orthopaedic Society (JBOS).:135.
Ewiss IG, Rewehy AI, Mohamed KA. Evaluation of Transpedicular Screws Fixation with Posterior Interbody Fusion by Cage in Management of Lumbar Spondylolisthesis. Al-Azhar International Medical Journal. 2023;4(3):16.
Moussa AE, Ali MS, Galal M. Outcome of Transpedicular Screw Fixation with Posterior Interbody Fusion in Management of Spondylolysthesis. International Journal of Medical Arts. 2020 Apr 1;2(2):358-64.
Omidi-Kashani F, Hassankhani EG, Shiravani R, Mirkazemi M. Surgical outcome of reduction and instrumented fusion in lumbar degenerative spondylolisthesis. Iranian Journal of Medical Sciences. 2016 Jan;41(1):13.
El-karamany M, Maghawry AA, Bakr AI. Management of Degenerative Lumbar Spine Disease by Posterior Lumbar Interbody Fusion and Percutaneous Pedicular Fixation. Benha Medical Journal. 2023 May 29.
El-Mor ES, Ragab A, Mansour ME. Transpedicular Screw Fixation for Degenerative Lumbar Spine Stenosis with Segmental Instability. The Egyptian Journal of Hospital Medicine. 2019 Jul 1;76(3):3791-6.
Urakawa H, Jones T, Samuel A, Vaishnav AS, Othman Y, Virk S, Katsuura Y, Iyer S, McAnany S, Albert T, Gang CH. The necessity and risk factors of subsequent fusion after decompression alone for lumbar spinal stenosis with lumbar spondylolisthesis: 5 years follow-up in two different large populations. The Spine Journal. 2020 Oct 1;20(10):1566-72.
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