Abstract
Introduction
Lumbar spine spondylolisthesis (LSS) has been surgically managed by interbody fusion using pedicle screw and rod fixation. Many surgeons advocate the use of an interbody fusion device (cage) to assist in fusion and increase the stability of the construct.
Objective
The aim of the study is to assess and compare the functional and radiological outcome of patients undergoing surgical fixation with or without interbody cage.
Materials and Methods
We performed a prospective nonrandomized study in adults aged 28 to 68 years with LSS. Enrolment was done between 2010 and 2012 at the Department of Orthopaedics and Department of Neurosurgery, Bangalore Medical College and Research Institute, Bangalore, India. Clinical follow-up at 6 weeks, 3, 6, and 12 months intervals regarding pain, fusion (AP, lateral and flexion—extension radiographs) and the functional outcome was evaluated by visual analog scale (VAS) pain rating, and Oswestry disability index (ODI), SF-36, modified Benzel Japanese Orthopaedic Association score.
Results
A total of 20 patients with LSS were enrolled. The mean age of patients at the time of surgery was 46.85 years (± 21.15). Mean follow-up duration 14 months (range, 12–24 months). Earliest union seen at 6 months follow-up in 30% of bone graft (BG) and 50% of cage group (CG). At end of 1 year 90% of BG and 100% of CG group showed radiological union. Average fusion rate were 10 and 8.5 months in BG and CG, respectively. Radicular improvements were seen in 70 and 90% of BG and CG, respectively. Functional outcome was significantly better at 3, 6 months, and 1 year in both the groups (p < 0.001). Complications were seen in 60 and 20% cases of BG and CG, respectively. Patient satisfaction was 80 and 90% in BG and CG, respectively. All patients returned to preinjury status except one in BG group.
Conclusion
Addition of an interbody fusion device (cage) helps in greater stability, lower implant failure, higher fusion rate, and better functional outcome in surgically treated patient of lumbar Spondylolisthesis at follow-up, however no significant difference seen between two groups (p < 0.3, 0.5, and 0.26).