Objective

High grade spondylolisthesis (HGS) is a quite rare entity and many techniques are available to address this condition. In 1994 Abdu et al. proposed a transdiscal fixation approach that achieved a good clinical outcome. We analyse outcome and fusion achieved in patients treated by transdiscal fixation after one-year follow-up.

Methods

We reviewed patients operated through transdiscal fixation since 2014 with a follow-up of at least one year, and compared preoperative and postoperative clinical measures (ODI, VAS and EQ-5D) and postoperative complications. Also, we analysed the degree of fusion on CT scan with Lenke and Birdwell criteria.

Results

Twelve patients were included in the study with a mean follow-up of 49.4 months (range 12.8 – 84.1 months). Three cases presented a Meyerding grade IV spondylolisthesis and 9 cases grade III. At one-year follow-up mean postoperative ODI, VAS and EQ5D scores improved (ODI 13.2 (range 0 – 30) vs 49.83 (range 15 – 71.1); p =.005). Equally this improvement was seen in the last follow-up (ODI 9.28 (range 0 – 35) vs 49.83 (range 15 – 71.1); p =.005). CT scan showed fusion grade A in 5 patients (41.6%), another 5 as grade B (41.6%) in Lenke classification. According to the Birdwell criteria 4 patients were classified as grade I (33.3%), 7 patients grade II (58.3%). None showed complications postoperatively or radiolucency in follow-up.

Conclusions

Transdiscal fixation shows a good clinical outcome that is maintained throughout a long time period and provides a reliable and suitable fusion.

中文翻译：

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L5-S1高度椎体滑脱经椎间盘固定术的远期疗​​效及融合率

客观的

高级别脊椎滑脱 (HGS) 是一种非常罕见的疾病，许多技术可用于解决这种情况。1994 年 Abdu 等人。提出了一种经椎间盘固定方法，取得了良好的临床效果。我们分析了一年随访后经椎间盘固定治疗的患者的结果和融合。

方法

我们回顾了自 2014 年以来通过椎间盘固定手术并随访至少一年的患者，并比较了术前和术后临床指标（ODI、VAS 和 EQ-5D）和术后并发症。此外，我们使用 Lenke 和 Birdwell 标准分析了 CT 扫描的融合程度。

结果

12 名患者被纳入研究，平均随访时间为 49.4 个月（范围 12.8-84.1 个月）。Meyerding IV级滑脱3例，III级9例。在一年的随访中，平均术后 ODI、VAS 和 EQ5D 评分有所改善（ODI 13.2（范围 0-30）vs 49.83（范围 15-71.1）；p =.005）。同样，在最后一次随访中也看到了这种改善（ODI 9.28（范围 0-35）vs 49.83（范围 15-71.1）；p =.005）。CT 扫描显示 5 例患者 (41.6%) 融合等级为 A，另外 5 例为 Lenke 分类中的 B 级 (41.6%)。根据 Birdwell 标准，4 名患者被归类为 I 级（33.3%），7 名患者被归类为 II 级（58.3%）。没有出现术后并发症或随访中的射线可透性。

结论

经椎间盘固定显示出良好的临床结果，可在很长一段时间内保持并提供可靠和合适的融合。