Authors: Andrzej Smętkowski, Tomasz Potaczek, Maciej Tęsiorowski
Transkrypt
Authors: Andrzej Smętkowski, Tomasz Potaczek, Maciej Tęsiorowski
Authors: Andrzej Smętkowski, Tomasz Potaczek, Maciej Tęsiorowski, Paweł Radło, Barbara Jasiewicz Department of Orthopedic Surgery and Rehabilitation, Zakopane, Poland Email: [email protected] Head of Department: professor Maciej Tęsiorowski To analize of complications and failures in patients treated surgically due to spondylolisthesis in one spine center } } } } 101 patients with spondylolisthesis operated between 2000 and 2010 Gender: 45 male, 56 female Mean age at surgery: 46 years [20-76] Type of spondylolisthesis according to Wiltse classification: 64 istchmic 20 degenerative 17 displastic } Grade of slippage: ◦ I°- 8 patients; ◦ II° - 79 patients; ◦ III° - 9 patients’ ◦ IV°- 5 patients } Level of slippage: ◦ L5/S1 - 82 patients ◦ L4/L5 – 19 patients } Angle of slippage: mean 13° [1 - 50] } Lumbar lordosis: mean 56° [24 – 90] } Surgical technique: ◦ Posterolateral fusion (PLF) - 61 patients ◦ Posterior lumbar interbody fusion + pedicle fixation (PLIF) - 50 patients Complications were noted in 29 cases (28.7%) } Complications were classified as: } ◦ hardware related, 15 cases (14.8%) screw breakage/rod breakage were present in 5 cases ◦ Intraoperative durotomy 5 cases (4.9%) ◦ Unsatisfactory subjective result – 5 patients (4.9%) ◦ Neurologic - 4 patients (3.9%) 40.00% 20.00% 23.25% 0.00% dysplastic 30.80% 32.50% istchmic degenerative 6 40.00% 60% Hardware related 20.00% 23.25% 0.00% dysplastic 50% Hardware related 50% Poor outcome 30.80% 32.50% istchmic degenerative 7 60% Hardware related 70 60 30% Durotomy 50 40 30 20 10 0 PLF PLIF } } Is proportional to: ◦ Grade of spondylolisthesis ◦ Angle of spondylolisthesis ◦ Angle of lumbar lordosis ◦ Lack of anterior fusion Is inveresly proportional to: ◦ Ferguson angle } } } The incidence of complications in slippage surgery remains high Surgical technique that ensures fusion of the anterior and posterior spinal column reduces the risk of hardware failure. Risk factors of unsatisfactory result are slippage percentage, angle of slippage and implant failure. } No authors have any potential conflict of interest