Posterior lateral distraction spondylodesis using the twofold sacral bar.

From January 1978 until March 1985 more than 500 patients were operated on by posterolateral distraction spondylodesis using Zielke's twofold sacral bar for stabilization of the lumbosacral joint. Over 50% of these patients presented with low-back pain with or without neurologic deficits. A considerable number of these had been preoperated one to ten times. Those who had not been operated on before had the best results concerning lumbar back pain and neurologic deficits. Only 49% of the multioperated back patients became pain-free. Nevertheless, even in this group, decompression through distraction proved to provide relief from neurologic deficits existing over a long period of time. Neurologic complications caused by this operation occurred only in 0.4%. Using the modification with additional transpeduncular screws, the rate of pseudarthrosis diminished from 20% to 5.5%. The authors estimate the posterolateral distraction spondylodesis using Zielke's twofold sacral knee to be a valuable operative treatment for stabilization of the lumbosacral joint.