Isthmic Spondylolisthesis, Surgical Procedure, Unspecified
Conditions
Keywords
Isthmic spondylolisthesis, vertebral fusion, combined approach, circumferential fusion, ALIF, posterior fusion
Brief summary
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.
Detailed description
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.
Interventions
PROCEDUREObservational study evaluating the results of an intervention for isthmic spondylolisthesis: surgical procedure with double approach: Anterior lumbar Interbody Fusion then postero-lateral fusion
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.
Sponsors
CMC Ambroise Paré
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* All patients aged over 18 years * With isthmic spondylolisthesis at L4-L5 or L5-S1 * Operated in our center with a double approach: Anterior lumbar interbody fusion then postero-lateral fusion * Consent for participation
Exclusion criteria
* Pseudarthrosis L5-S1
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Fusion status | From 6 months to 1 year after surgery | 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. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Restoration of the foraminal diameter | 3 months and 1 year after surgery | The foraminal diameter is measured to quantify the restoration of the foraminal diameter after surgery, making more room for the nerve root. |
| Correction of the spondylolisthesis-induced kyphosis after surgery | 3 months and 1 year after surgery | The lumbo-sacral angle is measured to quantify the correction of the spondylolisthesis-induced kyphosis after surgery. |
| Segmental lordosis | 3 months and 1 year after surgery | Segmental lordosis is measured with the L5-S1 lordosis, quantifying the correction at the spondylolisthesis level |
| Local Lordosis | 3 months and 1 year after surgery | Local Lordosis measured with the L4-S1 lordosis, quantifying the correction in the lower lumbar region |
| Back pain | Pre-operative, 3 months and 1 year after surgery | 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) |
| Sciatica | Pre-operative, 3 months and 1 year after surgery | 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) |
| Disability | Pre-operative, 3 months and 1 year after surgery | 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. |
| Complication rate | until 1 year after surgery | intra-operative, early and late post-operative complications (vascular injury, non-union, infection, etc…) |
Countries
France
Outcome results
None listed