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
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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
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Grade of slippage:
◦  I°- 8 patients;
◦  II° - 79 patients;
◦  III° - 9 patients’
◦  IV°- 5 patients
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Level of slippage:
◦  L5/S1 - 82 patients
◦  L4/L5 – 19 patients
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Angle of slippage: mean 13° [1 - 50]
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Lumbar lordosis: mean 56° [24 – 90]
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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:
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◦  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
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Is proportional to:
◦  Grade of spondylolisthesis
◦  Angle of spondylolisthesis
◦  Angle of lumbar lordosis
◦  Lack of anterior fusion
Is inveresly proportional to:
◦  Ferguson angle
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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.
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No authors have any potential conflict of interest