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Management of High-Grade Spondylolisthesis Including Reduction Techniques

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Spondylolisthesis

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Abstract

There exists significant controversy in the literature regarding the surgical treatment of high-grade spondylolisthesis: in situ fusion versus reduction, the timing of surgery, and the techniques for achieving fixation are highly varied. High-grade spondylolisthesis is a complicated, three-dimensional deformity with complex pathomechanics and secondary anatomic changes that develop over time. While the classification schemes and management modalities of high-grade spondylolisthesis continue to evolve with our understanding of these deformities, there is general agreement that surgical treatment of high-grade, unbalanced spondylolisthesis is the management of choice. While reduction and fixation of these high-grade slips are historically fraught with complications, including nerve injury and loss of fixation, in situ fusion is also not without reportedly severe complications. However, in the authors’ varied, multi-year experience, anatomic reduction with interbody fusion and posterior instrumentation has yielded excellent results with a relatively low complication rate.

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Author information

Authors and Affiliations

  1. Department of Neurological Surgery, Lille University Hospital, Lille, France

    Richard Assaker

  2. Department of Orthopaedic Surgery, Walter Reed National Military Medical Center, Bethesda, MD, USA

    Scott C. Wagner

  3. The Paley Orthopedic and Spine Institute at Saint Mary’s Medical Center, West Palm Beach, FL, USA

    Harry L. Shufflebarger

  4. The Spine Hospital, New York-Presbyterian/Columbia University Irving Medical Center, New York, NY, USA

    Ronald A. Lehman

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  1. Richard Assaker
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  2. Scott C. Wagner
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  3. Harry L. Shufflebarger
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  4. Ronald A. Lehman
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Editor information

Editors and Affiliations

  1. Stryker Spine, Brookfield, CT, USA

    Adam L. Wollowick

  2. Department of Orthopedic Surgery, Northwell Health, New Hyde Park, NY, USA

    Vishal Sarwahi

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Assaker, R., Wagner, S.C., Shufflebarger, H.L., Lehman, R.A. (2023). Management of High-Grade Spondylolisthesis Including Reduction Techniques. In: Wollowick, A.L., Sarwahi, V. (eds) Spondylolisthesis. Springer, Cham. https://doi.org/10.1007/978-3-031-27253-0_22

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  • DOI: https://doi.org/10.1007/978-3-031-27253-0_22

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  • Online ISBN: 978-3-031-27253-0

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