There have been many reports regarding various operative methods for spondylolytic spondylolisthesis. However, there have been no reports regarding the comparison between posterolateral fusion (PLF) with pedicle screw fixation (PSF) and anterior lumbar interbody fusion (ALIF) with PSF. The purpose of the current study was to compare the clinical outcomes of PLF with PSF and ALIF with PSF, and to help in the selection of treatment options. Fifty-six patients with spondylolytic spondylolisthesis who underwent PLF with PSF (group 1, 35 patients) or who underwent ALIF with PSF (group 2, 21 patients) were studied. Minimum follow-up was 2 years. Demographic variables and disease state were similar for the two groups. We studied operating time, amount of blood loss, duration of hospital stay, clinical outcomes, complications, time at which fusion was complete, fusion rate, and radiological measurements. There were no significant differences between the two groups in terms of the amount of blood loss, duration of hospital stay, back pain, radiating pain, fusion rate, or complication rate. However, in group 2, the operation time and the time at which fusion became complete was longer, and in group 1 there was significant radiological reduction loss. In conclusion, PLF with PSF was just as effective as ALIF with PSF in terms of clinical outcomes, but ALIF with PSF was superior to PLF with PSF in terms of the prevention of reduction loss. Anterior support would be helpful for preventing reduction loss in cases of spondylolytic spondylolisthesis of the lumbar spine.
Bibliographical noteFunding Information:
The senior author thanks the DAAD (Bonn), SOROS Foundation (Budapest) and EC (Brussels) for providing fellowships for research periods at Karlsruhe. The research was also supported by the Hungarian Scientific Research Foundation (OTKA I1848, OTKA I13.1545 and OTKA I14.F.53 59). We wish to thank Prof. T. Pocs (Eger, Hungary and Morogoro, Tanzania) for collecting the plant material, Dr. Marta Csik (Nat. Institute of Hygiene, Budapest) for preparing the electron micrographs as well as Ms. Sabine Zeiler and Mr. Michael Lang (both Karlsruhe) for assistance during the preparation of the manuscript.
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