Study of functional outcome of surgical management of lumbar spondylolisthesis With pedicle screw fixation and posterolateral fusion

Abstract

INTRODUCTION Low back pain ranks among the most frequently reported health issues globally. The primary causes of low back pain include injuries, overuse, and pressure on nerve tissue due to various conditions such as spondylolisthesis, disc herniation, spinal canal stenosis, and degenerative disc diseases. Spondylolisthesis is termed when the vertebra slides over another. It is one common cause of instability. It is derived from Greek words ‘Spondylos – vertebra’ and ‘olisthesis – slip. Spondylolisthesis can result from ligamentous laxity, defects in the pars interarticularis, and post-surgical procedures or may occur as a result of trauma. Pedicle screw fixation and posterolateral fusion is done to stabilize the unstable spinal segment by fusion and avoidance of further progression of slip. OBJECTIVES The aim of this study is to evaluate the functional outcome of surgical treatment for lumbar spondylolisthesis using pedicle screw fixation and posterolateral fusion MATERIALS AND METHODS It is a prospective observational study. The patients who met the inclusion and exclusion criteria were admitted to the Department of Orthopedics in B.L.D.E. (DEEMED TO BE UNIVERSITY) Shri B. M. Patil Medical College, Hospital and Research Centre. The patients were informed about the study in all respects and informed written consent was obtained. Period of study was between 1st may 2023 to 1st December 2024. Follow up period was of 6 months. RESULTS We studied 36 cases in our series with 16 males and 20 female patients. The radiological union was found to be 72.2 percent. From surgical incision to wound closure, the average operating time was 3.5 hours. The average blood loss was 248 ml. The improvement of post-operative VAS Score at six months mark was drastic and significant, as proven by a “p value” of < 0.00001. Improvement of quality of life, based on the Wilcoxon signed rank test comparing preoperative and postoperative modified Oswestry disability index score was statistically significant, showing significant reduction in post operative modified Oswestry disability index scores indicating significant improvement in quality of life. CONCLUSION In our study we have concluded that using a pedicle screw-rod system combined with posterolateral fusion is a safe and effective option, especially for low-grade cases. In terms of results, minimal postoperative complications were noted. The positive outcomes were primarily linked to neurological deficits present preoperatively, percentage of slip and number of spina segments fused. We would recommend pedicle screw-rod system combined with posterolateral fusion to be appropriate treatment for spondylolisthesis.