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European Spine Journal

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01-05-2012 | Original Article

“In situ” fusion or reduction in high-grade high dysplastic developmental spondylolisthesis (HDSS)

Authors: Monia Martiniani, Claudio Lamartina, Nicola Specchia

Published in: European Spine Journal | Special Issue 1/2012

Abstract

Purpose

To assess if the evaluation of the spino-pelvic balance can be effective in the surgical decision making of the high-grade high dysplastic developmental spondylolisthesis (HDDS).

Methods

Sixteen patients affected with high-grade HDDS (6 treated with “in situ” fusion, and 10 with reduction and fusion) were retrospectively evaluated. A clinical and radiological assessment of the deformity correction was carried out, with a minimum follow-up of 2 years. The differences between the pre- and postoperative measures were statistically analyzed using a two-tailed, paired t test.

Results

The six patients treated with “in situ” fusion showed no statistically significant change at the last follow-up relative to pelvic tilt (PT), sacral slope (SS), and grade, while the 10 patients treated with reduction showed significant changes: PT significantly decreased following surgery, while SS and grade significantly increased.

Conclusions

The analysis of the spino-pelvic sagittal balance allows to identify two types of HDDS: the balanced deformities, which do not need reduction, and the unbalanced deformities, in which correction is needed.

Akamaru T, Kawahara N, Yoon ST et al (2003) Adjacent segment motion after a simulated lumbar fusion in different sagittal alignments. Spine 28:1560–1566PubMed

Boos N, Marchesi D, Zuber K, Aebi M (1993) Treatment of severe spondylolisthesis by reduction and pedicular fixation. A 4–6 year follow-up study. Spine 18:1655–1661PubMedCrossRef

Bridwell KH, Sedgewick TA, O’Brien MF, Lenke LG, Baldus C (1993) The role of fusion and instrumentation in the treatment of degenerative spondylolisthesis with spinal stenosis. J Spinal Disord 6:461–472PubMedCrossRef

DeWald RL, Faut MM, Taddonio RF, Neuwrith MG (1981) Severe lumbosacral spondylolisthesis in adolescents and children: reduction and staged circumferential fusion. J Bone Joint Surg (Am) 63:619–626

Grob D, Humke T, Dvorak J (1996) Direct pediculo-body fixation in cases of spondylolisthesis with advanced intervertebral disc degeneration. Eur Spine J 5:281–285PubMedCrossRef

Hanson DS, Bridwell KH, Rhee JM, Lenke LG (2002) Correlation of pelvic incidence with low- and high-grade isthmic spondylolisthesis. Spine 27:2026–2029PubMedCrossRef

Hresko MT, Labelle H, Roussouly P, Berthonnaud E (2007) Classification of high grade spondylolistheses based on pelvic version and spinal balance: possible rationale for reduction. Spine 32(20):2208–2213PubMedCrossRef

Hresko MT, Hirschfeld R, Buerk A, Zurakowski D (2009) The effect of reduction and instrumentation of spondylolisthesis on spinopelvic sagittal alignment. J Pediatr Orthop 29:157–162PubMedCrossRef

Kawakami M, Tamaki T, Ando M, Yamada H, Hashizume H, Yoshida M (2002) Lumbar sagittal balance influences the clinical outcome after spondylolisthesis. Spine 27:59–64PubMedCrossRef

10.

Johnson JR, Kirwan EO (1983) The long-term results of fusion in situ for severe spondylolisthesis. J Bone Joint Surg (Br) 65:43–46

11.

Labelle H, Roussouly P, Berthonnaud E, Transfeldt E, O’Brien M, Hresko T, Chopin D, Dimnet J (2004) Spondylolisthesis, pelvic incidence and sagittal spino-pelvic balance: a correlation study. Spine 29(18):2049–2054PubMedCrossRef

12.

Labelle H, Roussouly P, Berthonnaud E, Dimnet J, O’Brien M (2005) The importance of spino-pelvic balance in L5-S1 developmental spondylolisthesis: a review of pertinent radiologic measurements. Spine 30(6 Suppl):S27–S34PubMedCrossRef

13.

Labelle H, Mac-Thiong J, Roussouly P (2011) Spino-pelvic sagittal balance of spondylolisthesis: a review and classification. Eur Spine J 20(Suppl 5):641–646PubMedCrossRef

14.

Lamartina C (2001) A square to indicate the unstable zone in severe spondylolisthesis. Eur Spine J 10(5):444–448PubMedCrossRef

15.

Lamartina C, Zavatsky JM, Petruzzi M, Specchia N (2009) Novel concepts in the evaluation and treatment of high-dysplastic spondylolisthesis. Eur Spine J 18(Suppl 1):133–142PubMedCrossRef

16.

Lazennec JY, Ramare S, Arafati N et al (2000) Sagittal alignment in lumbosacral fusion: relations between radiological parameters and pain. Eur Spine J 9:47–55PubMedCrossRef

17.

Legaye J, Duval-Beaupère G, Hecquet J et al (1998) Pelvic incidence: a fundamental pelvic parameter for the 3D regulation of spinal sagittal curves. Eur Spine J 7:99–103PubMedCrossRef

18.

Marchetti PG, Bartolozzi P (1997) Classification of spondylolisthesis as a guideline for treatment. In: Bridwell KH, DeWald RL (eds) The textbook of spinal surgery, 2nd edn. Lippincott-Raven, Philadelphia, pp 1211–1254

19.

Mardjetko S, Connolly P, Shott S (1994) Degenerative spondylolisthesis: a meta-analysis of the literature 1970–1993. Spine 10:2256S–2265SCrossRef

20.

Marty C, Boisaubert B, Descamps H et al (2002) The sagittal anatomy of the sacrum among young adults, infants, and spondylolisthesis patients. Eur Spine J 11:119–125PubMedCrossRef

21.

Min K, Liebscher Th, Rothenfluh D (2011) Sacral dome resection and single-stage posterior reduction in the treatment of high-grade high dysplastic spondylolisthesis in adolescents and young adults. Eur Spine J 20. doi:10.1007/s00586-011-1949-5

22.

Molinari RW, Bridwell KH, Lenke LG, Baldus C (2002) Anterior column support in surgery for high-grade, isthmic spondylolisthesis. Clin Orthop 394:109–120PubMedCrossRef

23.

Moller H, Hedlund R (2000) Surgery versus conservative management in adult isthmic spondylolisthesis: a prospective randomized study: part 1. Spine 25:1711–1715PubMedCrossRef

24.

Poussa M, Schlenzka D, Seitsalo S, Ylikoski M, Hurri H, Osterman K (1993) Surgical treatment of severe isthmic spondylolisthesis in adolescents: reduction or fusion in situ. Spine 18:894–901PubMedCrossRef

25.

Suk SI, Lee CK, Kim WJ, Lee JH, Cho KJ, Kim HG (1997) Adding posterior lumbar interbody fusion to pedicle screw fixation after decompression in spondylolytic spondylolisthesis. Spine 22:210–219PubMedCrossRef

Title: “In situ” fusion or reduction in high-grade high dysplastic developmental spondylolisthesis (HDSS)
Authors: Monia Martiniani
Claudio Lamartina
Nicola Specchia
Publication date: 01-05-2012
Publisher: Springer-Verlag
Published in: European Spine Journal / Issue Special Issue 1/2012
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-012-2230-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

“In situ” fusion or reduction in high-grade high dysplastic developmental spondylolisthesis (HDSS)

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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