Outcome analysis following posterior instrumentation, decompression, and intertransverse fusion for degenerative lumbar spondylolisthesis

Abstract

Background: Degenerative spondylolisthesis is one of the most common causes for low back ache and radiculopathy and causes disability. Various surgical procedures have been described to achieve fusion. Intertransverse fusion (ITF) is the simplest of all with very less rates of complications. Objectives: The objective of this study was to analyze the outcomes of posterior instrumentation with pedicle screws, decompression, and ITF in degenerative lumbar spondylolisthesis based on the clinical outcome with Oswestry Disability Index (ODI) questionnaire and also to assess the fusion rates. Materials and Methods: A single-grouped, prospective interventional study was conducted from June 2015 to June 2019 in a tertiary care hospital. A total of 44 patients with Grades I and II degenerative lumbar spondylolisthesis of the Meyerding radiological grading system were included in the study. Posterior instrumentation with pedicle screws, decompression, and ITF was performed in all these patients. Patients were assessed preoperatively and postoperatively using ODI-based questionnaire. Results: The mean preoperative Oswestry score was 58.33 ± 10.66 and the mean postoperative score was 24.26 ± 12.80 at 1-year follow-up. Fifty percent had excellent and another 50% had better results with overall 100% satisfactory results, with a mean preoperative and postoperative difference of 34.07 ± 18.00 for ODI. All patients achieved radiological fusion. Conclusion: The study observed that ITF for Grades I and II degenerative lumbar spondylolistheses is a safe and simple fusion procedure with lesser rates of complications and higher rates of radiological fusion.