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This study aims to evaluate clinical and radiological outcomes of isthmic spondylolisthesis surgically treated with combined approach. The goal is to demonstrate that it is a safe and efficient technique to treat isthmic spondylolisthesis. There is very little literature concerning this procedure.
Isthmic spondylolisthesis can cause back and leg pain. If pain persists after well conducted medical management, a surgical treatment can be proposed. Even though the goal is consensual, there are plenty of ways to reach vertebral fusion: ALIF, PLIF, TLIF, Posterior fusion only, etc… This study aims to evaluate clinical and radiological outcomes of isthmic spondylolisthesis surgically treated with combined approach. The goal is to demonstrate that it is a safe and efficient technique to treat isthmic spondylolisthesis using standard XRays, CT Scan and patient reported outcome measurements. There is very little literature concerning this procedure.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Single cohort of operated patients | One group of patients: isthmic spondylolisthesis operated in our center using a double approach technique |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Observational study evaluating the results of an intervention for isthmic spondylolisthesis: surgical procedure with double approach: Anterior lumbar Interbody Fusion then postero-lateral fusion | Procedure | First in supine position, an ALIF is performed: with a Pfannenstiel incision, through a retroperitoneal approach, a discectomy is performed at the level of the spondylolisthesis then a cage is placed between the two vertebral bodies. Then, in prone position, a standard posterior approach is performed, pedicle screws are placed to achieve a postero-lateral fusion. A decompression may be associated. |
| Measure | Description | Time Frame |
|---|---|---|
| Fusion status | Every patient has a CT-Scan of the lumbar spine done to check fusion status. The interpretation is made by the surgeon who did the surgery and one independent reviewer. | From 6 months to 1 year after surgery |
| Measure | Description | Time Frame |
|---|---|---|
| Restoration of the foraminal diameter | The foraminal diameter is measured to quantify the restoration of the foraminal diameter after surgery, making more room for the nerve root. | 3 months and 1 year after surgery |
| Correction of the spondylolisthesis-induced kyphosis after surgery |
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Inclusion Criteria:
Exclusion Criteria:
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Consecutive cohort of patients operated in our center from 2013 to 2017
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| CMC Ambroise Pare | Neuilly-sur-Seine | ÃŽle-de-France Region | 92200 | France |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 35172449 | Result | Khalife M, Dauzac C, Lenoir T, Magrino B. Isthmic spondylolisthesis treated with circumferential arthrodesis (ALIF and posterior fixation): correction, fusion and indirect decompression. Acta Orthop Belg. 2021 Dec;87(4):787-794. doi: 10.52628/87.4.27. |
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The lumbo-sacral angle is measured to quantify the correction of the spondylolisthesis-induced kyphosis after surgery. |
| 3 months and 1 year after surgery |
| Segmental lordosis | Segmental lordosis is measured with the L5-S1 lordosis, quantifying the correction at the spondylolisthesis level | 3 months and 1 year after surgery |
| Local Lordosis | Local Lordosis measured with the L4-S1 lordosis, quantifying the correction in the lower lumbar region | 3 months and 1 year after surgery |
| Back pain | Measured with Lumbar Visual Analogic Scale. The patient quantifies his back pain with a number, ranging from 0 to 10 (0 = no pain, 10= worst possible pain) | Pre-operative, 3 months and 1 year after surgery |
| Sciatica | Measured with Radicular Visual Analogic Scale. The patient quantifies his leg pain with a number, ranging from 0 to 10 (0 = no pain, 10= worst possible pain) | Pre-operative, 3 months and 1 year after surgery |
| Disability | Measured with the ODI (Oswestry Disability Index). The patient answers 10 questions concerning his daily life and the disability caused by his back problem, giving a global score. 0 is equated with no disability and 100 is the maximum disability possible. | Pre-operative, 3 months and 1 year after surgery |
| Complication rate | intra-operative, early and late post-operative complications (vascular injury, non-union, infection, etc…) | until 1 year after surgery |