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Best Treatment for Long-Term Results with Spondylolisthesis

Spondylolisthesis is a condition in the spine where one vertebra has slipped forward over the vertebra below it. It's caused by a fracture of the supporting column of the vertebral bone called the pars interarticularis.

When the vertebra slips forward over half of the lower vertebra, it's called a high-grade spondylolisthesis. Surgery is needed to fuse the spine and hold it in place to keep it from slipping any farther.

But what method of fusion works best for this problem? There are three fusion methods: anterior (front), posterior (back), and circumferential (all the way around). What are the long-term results of the different fusion types? That's what the authors of this study tried to find out.

They compared X-rays, spinal mobility, function, and trunk strength for patients divided into three groups. The three groups corresponded to the three types of fusion methods. All patients were 20 years old or younger. Lumbar fusion was done at the L5-S1 level for all patients using one of the three fusion methods described.

The authors report that the circumferential fusion had slightly better long-term results than the anterior or posterior methods. For the most past, X-rays and function were the same among the three groups. All fusion methods were successful in stopping further slip of the vertebra.

References: Tommi Lamberg, MD, PhD, et al. Uninstrumented In Situ Fusion for High-Grade Childhood and Adolescent Isthmic Spondylolisthesis: Long-Term Outcome. In Journal of Bone and Joint Surgery. March 2007. Vol. 89-A. No. 3. Pp. 512-518.

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