Zeitschrift fur Orthopadie und ihre Grenzgebiete · 2001
[Staged reposition and fusion with external fixator in spondyloptosis].
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Wild A, Jäger M, Webb J K
Аннотация
PROBLEM: Is the staged reduction by an external fixateur and combined fusion of slipping vertebra an adequate surgical treatment for lumbar spondyloptosis?
METHODS: 11 patients with symptomatic lumbar spondyloptosis were treated using a technique of slow reduction and combined posterior and anterior approach. The first stage consists of a posterior approach with the application of the external fixateur. After staged reduction the anterior and posterior fusion are performed. All patients were pre- and postoperatively classified by radiological and clinical criteria. We report improvements in pain, activities of daily live, and cosmetic appearance. The average follow-up was over three years.
RESULTS: Postoperatively one patient failed to reduce, and one developed a subsequent L4/L5 spondylolisthesis. All patients showed a solid spondylodesis with no significant loss of reduction. There was no patient with any neurological deficit. The mean correction of the slipping at follow-up was 84.5%. 9 patients were satisfied with the result.
CONCLUSION: With gradual instrumented reduction by external fixateur, an anatomic reduction is nearly obtained and excellent clinical results in the treatment of spondyloptosis can be achieved.
METHODS: 11 patients with symptomatic lumbar spondyloptosis were treated using a technique of slow reduction and combined posterior and anterior approach. The first stage consists of a posterior approach with the application of the external fixateur. After staged reduction the anterior and posterior fusion are performed. All patients were pre- and postoperatively classified by radiological and clinical criteria. We report improvements in pain, activities of daily live, and cosmetic appearance. The average follow-up was over three years.
RESULTS: Postoperatively one patient failed to reduce, and one developed a subsequent L4/L5 spondylolisthesis. All patients showed a solid spondylodesis with no significant loss of reduction. There was no patient with any neurological deficit. The mean correction of the slipping at follow-up was 84.5%. 9 patients were satisfied with the result.
CONCLUSION: With gradual instrumented reduction by external fixateur, an anatomic reduction is nearly obtained and excellent clinical results in the treatment of spondyloptosis can be achieved.