Skip to main content
SpringerLink
Log in

Long-Term Clinical and Radiological Evaluation of Low-Grade Lumbar Spondylolisthesis Stabilization with Rigid Percutaneous Pedicle Screws

  • Chapter
  • First Online:
The Funnel: From the Skull Base to the Sacrum

Part of the book series: Acta Neurochirurgica Supplement ((NEUROCHIRURGICA,volume 135))

  • 271 Accesses

Abstract

The armamentarium of surgical treatment options for lumbar spondylolisthesis (LS) includes decompression alone, stabilization with interlaminar devices, or instrumented fusion, through open or minimally invasive approaches. Despite its safe profuse use in distinctive lumbar spine disorders, using percutaneous pedicle screws (PPSs) alone to stabilize LS has never been described before. We performed a retrospective study of prospectively collected data, enrolling 24 patients with LS and scrutinizing clinical and radiological outcomes. A statistically significant decrease in visual analog scale (VAS) scores (p < 0.001) and Oswestry Disability Index (ODI) scores (p < 0.001) was observed, as was a reduction in the intake of acetaminophen after surgery (p = 0.022). In the long-term, PPS effectively reduced the index-level range of motion (p < 0.001), reduced preoperative slippage (p = 0.03), and maintained foraminal height, thus accounting for the positive clinical outcomes. It induced a significant segmental kyphotic effect (p < 0.001) that was compensated for by a favorable increase in the pelvic incidence minus lumbar lordosis (PI-LL) index (0.028).

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Fox MW, Onofrio BM, Onofrio BM, Hanssen AD. Clinical outcomes and radiological instability following decompressive lumbar laminectomy for degenerative spinal stenosis: a comparison of patients undergoing concomitant arthrodesis versus decompression alone. J Neurosurg. 1996;85(5):793–802.

    Article  CAS  PubMed  Google Scholar 

  2. Grob D, Benini A, Junge A, Mannion AF. Clinical experience with the Dynesys semirigid fixation system for the lumbar spine: surgical and patient-oriented outcome in 50 cases after an average of 2 years. Spine. 2005;30(3):324–31.

    Article  PubMed  Google Scholar 

  3. Austevoll IM, Hermansen E, Fagerland MW, Storheim K, Brox JI, Solberg T, Rekeland F, Franssen E, Weber C, Brisby H, Grundnes O, Algaard K, Böker T, Banitalebi H, Indrekvam K, Hellum C, NORDSTEN-DS Investigators. Decompression with or without fusion in degenerative lumbar spondylolisthesis. N Engl J Med. 2021;385(6):526–38.

    Article  PubMed  Google Scholar 

  4. Deyo RA, Mirza SK, Martin BI, Kreuter W, Goodman DC, Jarvik JG. Trends, major medical complications, and charges associated with surgery for lumbar spinal stenosis in older adults. JAMA. 2010;303(13):1259–65.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Newcomer K, Laskowski ER, Yu B, Johnson JC, An KN. The effects of a lumbar support on repositioning error in subjects with low back pain. Arch Phys Med Rehabil. 2001;82(7):906–10.

    Article  CAS  PubMed  Google Scholar 

  6. Savarese LG, Menezes-Reis R, Bonugli GP, Herrero C, Defino H, Nogueira-Barbosa MH. Spinopelvic sagittal balance: what does the radiologist need to know? Radiol Bras. 2020;53(3):175–84.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Abdu WA, Lurie JD, Spratt KF, Tosteson AN, Zhao W, Tosteson TD, Herkowitz H, Longely M, Boden SD, Emery S, Weinstein JN. Degenerative spondylolisthesis: does fusion method influence outcome? Four-year results of the spine patient outcomes research trial. Spine. 2009;34(21):2351–60.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Mardjetko SM, Connolly PJ, Shott S. Degenerative lumbar spondylolisthesis. A meta-analysis of literature 1970–1993. Spine. 1994;19(20 Suppl):2256S–65S.

    Article  CAS  PubMed  Google Scholar 

  9. Fischgrund JS, Mackay M, Herkowitz HN, Brower R, Montgomery DM, Kurz LT. 1997 Volvo Award winner in clinical studies. Degenerative lumbar spondylolisthesis with spinal stenosis: a prospective, randomized study comparing decompressive laminectomy and arthrodesis with and without spinal instrumentation. Spine. 1997;22(24):2807–12.

    Article  CAS  PubMed  Google Scholar 

  10. Goel A, Ranjan S, Shah A, Patil A, Vutha R. Lumbar canal stenosis: analyzing the role of stabilization and the futility of decompression as treatment. Neurosurg Focus. 2019;46(5):E7.

    Article  PubMed  Google Scholar 

  11. Schaeren S, Broger I, Jeanneret B. Minimum four-year follow-up of spinal stenosis with degenerative spondylolisthesis treated with decompression and dynamic stabilization. Spine. 2008;33(18):E636–42.

    Article  PubMed  Google Scholar 

  12. Lad SP, Babu R, Baker AA, Ugiliweneza B, Kong M, Bagley CA, Gottfried ON, Isaacs RE, Patil CG, Boakye M. Complications, reoperation rates, and health-care cost following surgical treatment of lumbar spondylolisthesis. J Bone Joint Surg Am. 2013;95(21):e162.

    Article  PubMed  Google Scholar 

  13. Gillespie KA, Dickey JP. Biomechanical role of lumbar spine ligaments in flexion and extension: determination using a parallel linkage robot and a porcine model. Spine. 2004;29(11):1208–16.

    Article  PubMed  Google Scholar 

  14. Davis R, Auerbach JD, Bae H, Errico TJ. Can low-grade spondylolisthesis be effectively treated by either coflex interlaminar stabilization or laminectomy and posterior spinal fusion? Two-year clinical and radiographic results from the randomized, prospective, multicenter US investigational device exemption trial: clinical article. J Neurosurg Spine. 2013;19(2):174–84.

    Article  PubMed  Google Scholar 

  15. Zhao Q, Zhang H, Hao D, Guo H, Wang B, He B. Complications of percutaneous pedicle screw fixation in treating thoracolumbar and lumbar fracture. Medicine. 2018;97(29):e11560.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Regev GJ, Lee YP, Taylor WR, Garfin SR, Kim CW. Nerve injury to the posterior rami medial branch during the insertion of pedicle screws: comparison of mini-open versus percutaneous pedicle screw insertion techniques. Spine. 2009;34(11):1239–42.

    Article  PubMed  Google Scholar 

  17. Cagli S, Crawford NR, Sonntag VK, Dickman CA. Biomechanics of grade I degenerative lumbar spondylolisthesis. Part 2: treatment with threaded interbody cages/dowels and pedicle screws. J Neurosurg. 2001;94(1 Suppl):51–60.

    CAS  PubMed  Google Scholar 

  18. Pradhan BB, Turner AW, Zatushevsky MA, Cornwall GB, Rajaee SS, Bae HW. Biomechanical analysis in a human cadaveric model of spinous process fixation with an interlaminar allograft spacer for lumbar spinal stenosis: laboratory investigation. J Neurosurg Spine. 2012;16(6):585–93.

    Article  PubMed  Google Scholar 

  19. Kuraishi S, Takahashi J, Mukaiyama K, Shimizu M, Ikegami S, Futatsugi T, Hirabayashi H, Ogihara N, Hashidate H, Tateiwa Y, Kinoshita H, Kato H. Comparison of clinical and radiological results of posterolateral fusion and posterior lumbar interbody fusion in the treatment of L4 degenerative lumbar spondylolisthesis. Asian Spine J. 2016;10(1):143–52.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Fujimori T, Le H, Schairer WW, Berven SH, Qamirani E, Hu SS. Does transforaminal lumbar interbody fusion have advantages over posterolateral lumbar fusion for degenerative spondylolisthesis? Global Spine J. 2015;5(2):102–9.

    Article  PubMed  Google Scholar 

  21. Ferrero E, Ould-Slimane M, Gille O, Guigui P, French Spine Society (SFCR). Sagittal spinopelvic alignment in 654 degenerative spondylolisthesis. Eur Spine J. 2015;24(6):1219–27.

    Article  PubMed  Google Scholar 

  22. Schwab F, Lafage V, Patel A, Farcy JP. Sagittal plane considerations and the pelvis in the adult patient. Spine. 2009;34(17):1828–33.

    Article  PubMed  Google Scholar 

  23. Blumenthal C, Curran J, Benzel EC, Potter R, Magge SN, Harrington JF Jr, Coumans JV, Ghogawala Z. Radiographic predictors of delayed instability following decompression without fusion for degenerative grade I lumbar spondylolisthesis. J Neurosurg Spine. 2013;18(4):340–6.

    Article  PubMed  Google Scholar 

  24. Wang T, Ding W. Risk factors for adjacent segment degeneration after posterior lumbar fusion surgery in treatment for degenerative lumbar disorders: a meta-analysis. J Orthop Surg Res. 2020;15(1):582.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Kim CH, Chung CK, Choi Y, Kim MJ, Kim MJ, Shin S, Yang SH, Hwang SH, Kim DH, Park SB, Lee JH. Increased proportion of fusion surgery for degenerative lumbar spondylolisthesis and changes in reoperation rate: a nationwide cohort study with a minimum 5-year follow-up. Spine. 2019;44(5):346–54.

    Article  PubMed  Google Scholar 

  26. Brodke DS, Annis P, Lawrence BD, Woodbury AM, Daubs MD. Reoperation and revision rates of 3 surgical treatment methods for lumbar stenosis associated with degenerative scoliosis and spondylolisthesis. Spine. 2013;38(26):2287–94.

    Article  PubMed  Google Scholar 

Download references

Conflict of Interest

The authors declare that they have no conflicts of interest to disclose.

Author information

Authors and Affiliations

  1. Department of Neurosurgery, Hospital Center of Vila Nova de Gaia/Espinho, Porto, Portugal

    L. Pereira, V. Pinto, R. Reinas, D. Kitumba & O. L. Alves

  2. Department of Neurosurgery, Hospital Américo Boavida, Angola, Portugal

    D. Kitumba

  3. Department of Neurosurgery, Hospital Lusíadas Porto, Porto, Portugal

    O. L. Alves

Authors
  1. L. Pereira
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. V. Pinto
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. R. Reinas
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. D. Kitumba
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. O. L. Alves
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Institute of Neurosurgery, Catholic University of Rome, Rome, Italy

    Massimiliano Visocchi

Rights and permissions

Reprints and permissions

Copyright information

© 2023 The Author(s), under exclusive license to Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Pereira, L., Pinto, V., Reinas, R., Kitumba, D., Alves, O.L. (2023). Long-Term Clinical and Radiological Evaluation of Low-Grade Lumbar Spondylolisthesis Stabilization with Rigid Percutaneous Pedicle Screws. In: Visocchi, M. (eds) The Funnel: From the Skull Base to the Sacrum. Acta Neurochirurgica Supplement, vol 135. Springer, Cham. https://doi.org/10.1007/978-3-031-36084-8_64

Download citation

  • DOI: https://doi.org/10.1007/978-3-031-36084-8_64

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-031-36083-1

  • Online ISBN: 978-3-031-36084-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation