A novel approach to partial reduction of high-grade spondylolisthesis with offset rods - A report of two cases.

High-grade spondylolisthesis (HGS) remains a difficult entity to treat, given the high rate of complications following surgical correction of such a spinal deformity. Reduction of spondylolisthesis may be associated with traction injury to the L5 nerve root due to stretching. We report on two cases of HGS where a novel surgical technique of offset rods was used for partial reduction of spondylolisthesis thereby reducing L5 nerve root traction. Both cases had more than 50% correction of translation with good correction of slip angle and satisfactory clinical outcomes were achieved at the final follow-up. In this study, we report on two cases of HGS treated with offset rod constructs. These rod constructs provide partial reduction, improving slip angle at the listhesis while reducing nerve root stress caused by full reduction and fixation. In comparison to previously described constructs, offset rods provide greater construct modularity and freedom to create constructs better suited to each patient's pathology.