Volume 22, Number 4 (2-2009)                   Med J Islam Repub Iran 2009 | Back to browse issues page

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Behtash H, Ameri E, Ganjavian M, Omidi-Kashani F, Nojomi M. In situ fusion for spondylolysis” is regaining its lost popularity. Med J Islam Repub Iran. 2009; 22 (4) :175-182
URL: http://mjiri.iums.ac.ir/article-1-15-en.html

Assistant Professor of Orthopedic, Spinal fellowship, Mashhad University of Medical Sciences, , omidif@mums.ac.ir
Abstract:   (3916 Views)


 Background: Spondylolysis and spondylolisthesis can be associated with significant

 low back pain, especially in physically active adolescents. Non-operative management

 is usually successful in improving symptoms, but surgical intervention is

 occasionally required. The aim of this study was to determine the effect of in situ posterolateral

 fusion in the treatment of refractory cases with spondylolysis.

 Methods: In this prospective before and after study, we described our experience

 in13 patients managed by in situ fusion after failing multimodality non-operative

 treatment. All surgical procedures were performed by the senior author and by a similar

 technique. The spondylolytic vertebra and the one below were fused, in situ. Finally,

 clinical outcome and recovery rates of clinical symptoms were evaluated by

 Henderson’s functional capacity and Oswestry Disability Index version 2.1, respectively.

 Results: The mean duration of non-operative management was 36 (12-72)

 months. There were 8 males and 5 females. Average pre- and postoperative Oswestry

 Disability Indices were 28.4%±13.7% and 4.9±7.8 respectively (P=0.001, significant).

 All patients had follow-up contact on an average of 42.3 months (range 30 - 62

 months). Based on Henderson’s clinical outcome functional capacity at the final follow-

 up stage clinical outcomes were excellent in 10, good in 2 and poor in 1 patient.

 The case with poor result had a pseudoarthrosis and was re-oprated. Finally he had an

 excellent outcome.

 Conclusion: We accept that the number of our cases is not high significantly but it

 can be claimed that in situ fusion is a safe and effective modality to treat symptomatic

 patients with spondylolysis and low-grade spondylolisthesis. A study with much

 more cases is strongly recommended.

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Type of Study: Original Research | Subject: Orthopedic Surgery

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