الفهرس 
Title : Influence of the Posterior Lumbar Interbody Fusion on the Spine- Pelvic Parameters in High Grade Spondylolisthesis: Clinical and Radiological Outcomes
ContantsOnly 14 pages are availabe for public view
 |  | from | 156 |  |  |
| | | from | 156 | | |
Abstract
The relationship of the pelvis to the spine has previously been overlooked, and its importance in sagittal balance has been underestimated. There is a crucial interplay between structural pelvic features, spinopelvic parameters, and sagittal alignment in both normal volunteers and patients with high grade spondylolisthesis with relation between clinical and radiological outcomes.
Purpose: To evaluate the sagittal balance improvement in surgically treated patients with high grade Lytic Spondylolisthesis treated with PLIF and its relation to clinical outcome.
Patient sample: Prospective case study of 30 patients with high grade Lytic Spondylolisthesis with follows up of at least 12 months.
Outcome measures: Patients were evaluated by the Visual Analogical Scale (VAS) for low back pain (LBP) and leg pain (LP) and Oswestry Disability Index (ODI). The radiological evaluation of pelvic incidence, pelvic tilt and sacral slope, were done and evaluation of fusion followed the Brantigan methodology depending on X-ray at 6&12 months.
Methods: It consisted of a prospectively collected consecutive series of 30 patients with high grade Lytic Spondylolisthesis who met the inclusion criteria treated between September 2019 and August 2022. All cases were managed by posterolateral fusion (PLF) added to posterior interbody fusion (PLIF) in Cairo University hospital, and Alharam hospital.
Results: All patients achieved satisfactory results as regards the back pain, radicular pain and neurologic deficits. ODI significantly improved from mean 69.37±5.49 SD to 10.97±2.14 at 12 months (P <0.001). Mean Back pain VAS decreased significantly frommean 7.76 ±0.71SD to 0.93±0.37 at 12 months (P <0.001). Mean Leg pain VAS decreased significantly from mean 7.83±0.65 SD to 0.07±0.25 SD at 12 months (P <0.001). Pelvic incidence, pelvic tilt and sacral slope are also improved from mean 69.20±2.35 SD, 27.40±3.65 and 42.97±2.61 to 33.77±2.31, 7.73±1.39& 24.20±2.46 respectively by the end of the study. Values of PI and PT are statistically significant (P <0.001). Fusion improved from mean 4.17±0.83 SD by 6th month to 4.70±0.60by one year.
Two patients were complicated by dural tear (6.7%), two patients had superficial infection (6.7%) and three patients complicated delayed fusion (10%). None had undergone a revision surgery.