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Computed tomography- and fluoroscopy-guided percutaneous screw fixation of low-grade isthmic spondylolisthesis in adults: a new technique

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Abstract

Objectives

To evaluate the feasibility of computed tomography (CT)- and fluoroscopy-guided percutaneous screw fixation for the treatment of low-grade isthmic spondylolisthesis in adults.

Methods

Ten consecutive adult patients (four men and six women; mean age: 57.1 [range, 44–78 years]) were prospectively treated by percutaneous screw fixation for low-grade (six grade 1 and four grade 2) isthmic spondylolisthesis of L5. For each patient, two 4.0-mm Asnis III cannulated screws were placed to fix the pars interarticularis defects. All procedures were performed under local anaesthesia by using CT and fluoroscopy guidance. Post-operative outcome was assessed using the visual analogue scale and Oswestry Disability Index (ODI) scores.

Results

The procedure time ranged from 45 to 60 min. The mean screw length was 27 mm (range, 24–32 mm). The VAS and ODI measurements ± SD decreased from 7.8 ± 0.9 preoperatively to 1.5 ± 1.1 at the last 2-year follow-up, and from 62.3 ± 17.2 to 15.1 ± 6.0, respectively (P < 0.001 in both cases). Neither slip progression nor screw failure was noted.

Conclusions

This feasibility study showed that CT- and fluoroscopy-guided percutaneous screw fixation could be a rapid, safe and effective method of treating low-grade isthmic spondylolisthesis.

Key Points

• CT- and fluoroscopy-guided percutaneous screw fixation of isthmic spondylolisthesis is feasible.

• It could become an effective method to treat low-grade isthmic spondylolisthesis.

• Percutaneous trans-isthmic screw fixation can be performed under local anaesthesia.

• This new technique can be performed as an outpatient procedure.

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Authors and Affiliations

  1. Department of Radiology, Hôpital Archet 2, Centre Hospitalo-Universitaire de Nice, 151, route Saint-Antoine de Ginestière, 06200, Nice, France

    Nicolas Amoretti, Laurent Huwart, Patrick Browaeys, Yasir Nouri & Caroline Ibba

  2. Department of Orthopedic Surgery, Hôpital Archet 2, Centre Hospitalo-Universitaire de Nice, Nice, France

    Pascal Boileau

  3. Department of Radiology, Hôpital Pellegrin, Centre Hospitalo-Universitaire de Bordeaux, Bordeaux, France

    Olivier Hauger

  4. Department of Radiology, Antoine Lacassagne Cancer Research Institute, Nice, France

    Pierre-Yves Marcy

Authors
  1. Nicolas Amoretti
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  2. Laurent Huwart
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  3. Olivier Hauger
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  4. Patrick Browaeys
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  6. Yasir Nouri
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  7. Caroline Ibba
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  8. Pascal Boileau
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Correspondence to Nicolas Amoretti.

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Amoretti, N., Huwart, L., Hauger, O. et al. Computed tomography- and fluoroscopy-guided percutaneous screw fixation of low-grade isthmic spondylolisthesis in adults: a new technique. Eur Radiol 22, 2841–2847 (2012). https://doi.org/10.1007/s00330-012-2536-9

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  • DOI: https://doi.org/10.1007/s00330-012-2536-9

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