Background: The purpose of the current study was to use the Iliac Bars Lever Reduction and Fixation System (IBLRFS) for Grades 1 and 2 spondylolytic spondylolisthesis, evaluate its stability and reductive efficacy, and examine the complications.
Methods: Between April 2005 and August 2006, 44 patients with Grades 1 and 2 spondylolytic spondylolisthesis were treated surgically: 21 patients underwent posterior Iliac Bars Lever Reduction and Fixation (IBRLFS), 23 patients were treated with traditional stabilization and reduction systems (SRS). The follow-up periods ranged from 1 to 2 years (mean, 1 year and 2 months). The clinical outcome, fusion rate, average percentile degree of displacement, displacement angle, sacral inclination, ratio of intervertebral height, and complications were evaluated. Operating time, blood loss, and duration of hospital stay were compared.
Results: There were no statistically significant differences between the 2 groups in blood loss, recovery rate, and radiographic results. However, there were statistically significant differences in operating time (P < .05), duration of hospital stay (P < .05). There were no cases of nonunion in the two groups. In the IBLRFS group, preoperatively, the average percentile degree of displacement, displacement angle, sacral inclination, and ratio of intervertebral height were 23.48% ± 5.36%, 2.2° ± 1.1°, 29.4° ± 6.5°, and 0.68 ± 0.21, respectively. Postoperatively, the respective measurements were 6.47% ± 1.49%, 10.3° ± 3.3°, 42.6° ± 8.1°, and 0.85 ± 0.12. No patients experienced major complications. In the SRS group, preoperatively, the average percentile degree of displacement, displacement angle, sacral inclination, and ratio of intervertebral height were 21.78% ± 5.16%, 2.3° ± 1.0°, 26.4° ± 8.5°, and 0.62 ± 0.25, respectively. Postoperatively, the respective measurements were 6.34% ± 2.01%, 9.8° ± 2.1°, 44.1° ± 7.6°, and 0.79 ± 0.23. One patient experienced a badly placed screw in the right pedicle of lumbar 4.
Conclusions: This kind of new fixation system (IBLRFS) was shown to be useful in the treatment of spondylolisthesis, and its use was associated with minimal complications after 14 months of mean follow-up.
Level of evidence: Therapeutic, case studies (level 4).
Keywords: Fusion; fixation; reduction; spondylolisthesis.