Surgical treatment of low grade lumbar spondylolisthesis

Hüseyin Doğu

doi:10.7197/cmj.1334716

Araştırma Makalesi

Yıl 2023, , 103 - 111, 30.09.2023

Hüseyin Doğu

https://doi.org/10.7197/cmj.1334716

Öz

Kaynakça

1. Santoni BG, Hynes RA, McGilvray KC, Rodriguez-Canessa G, Lyons AS, Henson MA, et al. Cortical bone trajectory for lumbar pedicle screws. Spine J. 2009;9:366-73.
2. Holly LT, Foley KT. Three-dimensional fluoroscopy-guided percutaneous thoracolumbar pedicle screw placement. Technical note. J Neurosurg. 2003;99;Suppl:324-9.
3. Lee CK, Park JY, Zhang HY. Minimally invasive transforaminal lumbar interbody fusion using a single interbody cage and a tubular retraction system: technical tips, and perioperative, radiologic and clinical outcomes. J Korean Neurosurg Soc. 2010;48:219-24.
4. Grob D, Humke T, Dvorak J. Direct pediculo-body fixation in cases of spondylolisthesis with advanced intervertebral disc degeneration. Eur Spine J. 1996;5:281-5.
5. Wang SJ, Han YC, Liu XM, Ma B, Zhao WD, Wu DS, et al. Fusion techniques for adult isthmic spondylolisthesis: a systematic review. Arch Orthop Trauma Surg. 2014;134:777-84.
6. Aimar E, Iess G, Mezza F, Gaetani P, Messina AL, Todesca A, et al. Complications of degenerative lumbar spondylolisthesis and stenosis surgery in patients over 80 s: comparative study with over 60 s and 70 s. Experience with 678 cases. Acta Neurochir (Wien). 2022;164:923-31.
7. Fehlings MG, Rabin D. Surgical complications in adult spondylolisthesis. J Neurosurg Spine. 2010;13:587-8; discussion 588.
8. Kirkaldy-Willis WH, Paine KW, Cauchoix J, McIvor G. Lumbar spinal stenosis. Clin Orthop Relat Res. 1974;(99):30-50.
9. Taillard WF. Etiology of spondylolisthesis. Clin Orthop Relat Res. 1976;(117):30-39.
10. Austevoll IM, Gjestad R, Solberg T, Storheim K, Brox JI, Hermansen E, et al. Comparative effectiveness of microdecompression Alone vs decompression plus instrumented fusion in lumbar degenerative spondylolisthesis. JAMA Netw Open. 2020;3:e2015015.
11. Chen SR, Gibbs CM, Zheng A, Dalton JF, Gannon EJ, Shaw JD, et al. Use of L5-S1 transdiscal screws in the treatment of isthmic spondylolisthesis: a technical note. J Spine Surg. 2021;7:510-5..
12. Zayan M, Hussien MA, El Zahlawy H. Pars interarticularis repair using pedicle screws and laminar hooks fixation technique in patients with symptomatic lumbar spondylolysis. SICOT J. 2022;8:13. 13. Pai VS, Hodgson B, Pai V. Repair of spondylolytic defect with a cable screw reconstruction. Int Orthop. 2008;32:121-5.
14. Tang L, Wu Y, Jing D, Xu Y, Wang C, Pan J. A Bayesian network meta-analysis of 5 different fusion surgical procedures for the treatment of lumbar spondylolisthesis. Med (Baltim). 2020;99:e19639.
15. Bydon M, Alvi MA, Goyal A. Degenerative lumbar spondylolisthesis: definition, natural history, conservative management, and surgical treatment. Neurosurg Clin N Am. 2019;30:299-304.
16. Dunn AS, Baylis S, Ryan D. Chiropractic management of mechanical low back pain secondary to multiple-level lumbar spondylolysis with spondylolisthesis in a United States Marine Corps veteran: a case report. J Chiropr Med. 2009;8:125-30.
17. Boyd ED, Mundluru SN, Feldman DS. Outcome of conservative management in the treatment of symptomatic spondylolysis and Grade I spondylolisthesis. Bull Hosp Jt Dis (2013) 2019;77:172-82.
18. Nava-Bringas TI, Romero-Fierro LO, Trani-Chagoya YP, Macías-Hernández SI, García-Guerrero E, Hernández-López M, et al. Stabilization exercises versus flexion exercises in degenerative spondylolisthesis: A randomized controlled trial. Phys Ther. 2021;101:pzab108.
19. Matsunaga S, Sakou T, Morizono Y, Masuda A, Demirtas AM. Natural history of degenerative spondylolisthesis. Pathogenesis and natural course of the slippage. Spine (Phila Pa 1976). 1990;15:1204-10. 20. Eismont FJ, Norton RP, Hirsch BP. Surgical management of lumbar degenerative spondylolisthesis. J Am Acad Orthop Surg. 2014;22:203-13.
21. Mori G, Mikami Y, Arai Y, Ikeda T, Nagae M, Tonomura H, et al. Outcomes in cases of lumbar degenerative spondylolisthesis more than 5 years after treatment with minimally invasive decompression: examination of pre- and postoperative slippage, intervertebral disc changes, and clinical results. J Neurosurg Spine. 2016;24:367-74.
22. Kimura R, Yoshimoto M, Miyakoshi N, Hongo M, Kasukawa Y, Kobayashi T, et al. Comparison of posterior lumbar interbody fusion and microendoscopic muscle-preserving interlaminar decompression for degenerative lumbar spondylolisthesis with >5-year follow-up. Clin Spine Surg. 2019;32:E380-5.
23. Jang JW, Park JH, Hyun SJ, Rhim SC. Clinical outcomes and radiologic changes after microsurgical bilateral decompression by a unilateral approach in patients with lumbar spinal stenosis and Grade I degenerative spondylolisthesis with a minimum 3-year follow-up. Clin Spine Surg. 2016;29:268-71.
24. Müslüman AM, Cansever T, Yılmaz A, Çavuşoğlu H, Yüce İ, Aydın Y. Midterm outcome after a microsurgical unilateral approach for bilateral decompression of lumbar degenerative spondylolisthesis. J Neurosurg Spine. 2012;16:68-76.
25. Pazarlis K, Frost A, Försth P. Lumbar spinal stenosis with degenerative spondylolisthesis treated with decompression Alone. A cohort of 346 patients at a large spine unit. Clinical outcome, complications and subsequent surgery. Spine (Phila Pa 1976). 2022;47:470-5.
26. Ghogawala Z, Dziura J, Butler WE, Dai F, Terrin N, Magge SN, et al. Laminectomy plus Fusion versus laminectomy Alone for Lumbar spondylolisthesis. N Engl J Med. 2016;374:1424-34.
27. Tsutsumimoto T, Shimogata M, Yoshimura Y, Misawa H. Union versus nonunion after posterolateral lumbar fusion: a comparison of long-term surgical outcomes in patients with degenerative lumbar spondylolisthesis. Eur Spine J. 2008;17:1107-12.
28. Martin CR, Gruszczynski AT, Braunsfurth HA, Fallatah SM, O’Neil J, Wai EK. The surgical management of degenerative lumbar spondylolisthesis: a systematic review. Spine (Phila Pa 1976). 2007;32:1791-8.
29. Endler P, Ekman P, Möller H, Gerdhem P. Outcomes of posterolateral fusion with and without instrumentation and of interbody fusion for isthmic spondylolisthesis: A prospective study. J Bone Joint Surg Am. 2017;99:743-52.
30. Ye YP, Chen D, Xu H. The comparison of instrumented and non-instrumented fusion in the treatment of lumbar spondylolisthesis: a meta-analysis. Eur Spine J. 2014;23:1918-26..
31. Cruz A, Ropper AE, Xu DS, Bohl M, Reece EM, Winocour SJ, et al. Failure in lumbar spinal fusion and current management modalities. Semin Plast Surg. 2021;35:54-62.
32. Jalanko T, Helenius I, Remes V, Lamberg T, Tervahartiala P, Yrjönen T, et al. Operative treatment of isthmic spondylolisthesis in children: a long-term, retrospective comparative study with matched cohorts. Eur Spine J. 2011;20:766-75.
33. Voor MJ, Mehta S, Wang M, Zhang YM, Mahan J, Johnson JR. Biomechanical evaluation of posterior and anterior lumbar interbody fusion techniques. J Spinal Disord. 1998;11:328-34.
34. DiPaola CP, Molinari RW. Posterior lumbar interbody fusion. J Am Acad Orthop Surg. 2008;16:130-9.
35. Guppy KH, Royse KE, Norheim EP, Harris JE, Brara HS. PLF versus PLIF and the fate of L5-S1: analysis of operative nonunion rates among 3065 patients with lumbar fusions from a regional spine registry. Spine (Phila Pa 1976). 2021;46:E584-93.
36. Okuda S, Fujimori T, Oda T, Maeno T, Yamashita T, Matsumoto T, et al. Factors associated with patient satisfaction for PLIF: patient satisfaction analysis. Spine Surg Relat Res. 2017;1:20-6.
37. Liu X, Wang Y, Qiu G, Weng X, Yu B. A systematic review with meta-analysis of posterior interbody fusion versus posterolateral fusion in lumbar spondylolisthesis. Eur Spine J. 2014;23:43-56.
38. Kim KT, Lee SH, Lee YH, Bae SC, Suk KS. Clinical outcomes of 3 fusion methods through the posterior approach in the lumbar spine. Spine (Phila Pa 1976). 2006;31:1351-7; discussion 1358.
39. Fritzell P, Hägg O, Wessberg P, Nordwall A, Swedish Lumbar Spine Study Group. Chronic low back pain and fusion: a comparison of three surgical techniques: a prospective multicenter randomized study from the Swedish lumbar spine study group. Spine (Phila Pa 1976). 2002;27:1131-41.
40. Inamdar DN, Alagappan M, Shyam L, Devadoss S, Devadoss A. Posterior lumbar interbody fusion versus intertransverse fusion in the treatment of lumbar spondylolisthesis. J Orthop Surg (Hong Kong). 2006;14:21-6.
41. Hallett A, Huntley JS, Gibson JN. Foraminal stenosis and single-level degenerative disc disease: a randomized controlled trial comparing decompression with decompression and instrumented fusion. Spine (Phila Pa 1976). 2007;32:1375-80.
42. Fischgrund JS, Mackay M, Herkowitz HN, Brower R, Montgomery DM, Kurz LT. 1997 Volvo Award winner in clinical studies. Degenerative lumbar spondylolisthesis with spinal stenosis: a prospective, randomized study comparing decompressive laminectomy and arthrodesis with and without spinal instrumentation. Spine (Phila Pa 1976). 1997;22:2807-12.
43. Gruskay JA, Webb ML, Grauer JN. Methods of evaluating lumbar and cervical fusion. Spine J. 2014;14:531-9.
44. Li Y, Zheng LM, Zhang ZW, He CJ. The effect of smoking on the fusion rate of spinal fusion surgery: A systematic review and meta-analysis. World Neurosurg. 2021;154:e222-35.
45. Luszczyk M, Smith JS, Fischgrund JS, Ludwig SC, Sasso RC, Shaffrey CI, et al. Does smoking have an impact on fusion rate in single-level anterior cervical discectomy and fusion with allograft and rigid plate fixation? Clinical article. J Neurosurg Spine. 2013;19:527-31.
46. Cummins D, Hindoyan K, Wu HH, Theologis AA, Callahan M, Tay B, et al. Reoperation and mortality rates following elective 1 to 2 level lumbar fusion: A large state database analysis. Glob Spine J. 2022;12:1708-14.
47. Suh SP, Jo YH, Jeong HW, Choi WR, Kang CN. Outcomes of revision surgery following instrumented posterolateral fusion in degenerative lumbar spinal stenosis: A comparative analysis between pseudarthrosis and adjacent segment disease. Asian Spine J. 2017;11:463-71.
48. Derman PB, Singh K. Surgical strategies for the treatment of lumbar pseudarthrosis in degenerative spine surgery: A literature review and case study. HSS J. 2020;16:183-7.
49. Schimmel JJ, Horsting PP, de Kleuver M, Wonders G, van Limbeek J. Risk factors for deep surgical site infections after spinal fusion. Eur Spine J. 2010;19:1711-9.

Surgical treatment of low grade lumbar spondylolisthesis

Yıl 2023, , 103 - 111, 30.09.2023

Hüseyin Doğu

https://doi.org/10.7197/cmj.1334716

Öz

Background Data: Lumbar spondylolisthesis is a prevalent cause of lower back pain and is a focal interest of spinal surgery. A diverse set of decompression and fusion techniques are used in surgery.

Purpose: To investigate the surgical and clinical outcomes patients with spondylolisthesis who received surgical intervention.

Materials and Methods: Data of 25 patients (15 women; 10 men; mean age, 48.8 ± 12.4 years; range, 27–66 years) with low-grade spondylolisthesis who received surgical intervention were retrospectively analyzed. Posterolateral and posterior interbody fusion was used in 17 and 8 patients, respectively, and 19 received posterior pedicle screws and 6 received only fusion and decompression.
Results: According to the Kirkaldy–Willis criteria, the clinical outcomes of 11 (44%), 9 (36%), 3 (12%), and 2 (8%) patients were rated excellent, good, fair, and poor, respectively, with a success rate of 80%. Furthermore, fusion was observed in 21 patients (84%). Favorable outcomes were achieved in 17 (90%) patients with pedicle screws and in 3 (50%) with only decompression and fusion (p=0.048; p<0.05). The rate of favorable outcome was 75% patients who smoked (p=0.226; p>0.05). Two out of three patients with revision surgery had poor clinical outcomes (p=0.091; p<0.05).

Conclusion: Addition of pedicle screw fixation to posterolateral fusion increases fusion rates and yields satisfactory clinical results. Previous history of surgery is a risk factor that should be considered before deciding to perform surgery. Furthermore, the transpedicular screw fixation technique can be made less complicated and effective via an effective and experienced teamwork. Herein, we reviewed recent studies and discussed the indications, complications, and outcome of surgical treatment of low-grade spondylolisthesis.

Anahtar Kelimeler

Lumbar spondylolisthesis, pedicle screws, fusion

Kaynakça

1. Santoni BG, Hynes RA, McGilvray KC, Rodriguez-Canessa G, Lyons AS, Henson MA, et al. Cortical bone trajectory for lumbar pedicle screws. Spine J. 2009;9:366-73.
2. Holly LT, Foley KT. Three-dimensional fluoroscopy-guided percutaneous thoracolumbar pedicle screw placement. Technical note. J Neurosurg. 2003;99;Suppl:324-9.
3. Lee CK, Park JY, Zhang HY. Minimally invasive transforaminal lumbar interbody fusion using a single interbody cage and a tubular retraction system: technical tips, and perioperative, radiologic and clinical outcomes. J Korean Neurosurg Soc. 2010;48:219-24.
4. Grob D, Humke T, Dvorak J. Direct pediculo-body fixation in cases of spondylolisthesis with advanced intervertebral disc degeneration. Eur Spine J. 1996;5:281-5.
5. Wang SJ, Han YC, Liu XM, Ma B, Zhao WD, Wu DS, et al. Fusion techniques for adult isthmic spondylolisthesis: a systematic review. Arch Orthop Trauma Surg. 2014;134:777-84.
6. Aimar E, Iess G, Mezza F, Gaetani P, Messina AL, Todesca A, et al. Complications of degenerative lumbar spondylolisthesis and stenosis surgery in patients over 80 s: comparative study with over 60 s and 70 s. Experience with 678 cases. Acta Neurochir (Wien). 2022;164:923-31.
7. Fehlings MG, Rabin D. Surgical complications in adult spondylolisthesis. J Neurosurg Spine. 2010;13:587-8; discussion 588.
8. Kirkaldy-Willis WH, Paine KW, Cauchoix J, McIvor G. Lumbar spinal stenosis. Clin Orthop Relat Res. 1974;(99):30-50.
9. Taillard WF. Etiology of spondylolisthesis. Clin Orthop Relat Res. 1976;(117):30-39.
10. Austevoll IM, Gjestad R, Solberg T, Storheim K, Brox JI, Hermansen E, et al. Comparative effectiveness of microdecompression Alone vs decompression plus instrumented fusion in lumbar degenerative spondylolisthesis. JAMA Netw Open. 2020;3:e2015015.
11. Chen SR, Gibbs CM, Zheng A, Dalton JF, Gannon EJ, Shaw JD, et al. Use of L5-S1 transdiscal screws in the treatment of isthmic spondylolisthesis: a technical note. J Spine Surg. 2021;7:510-5..
12. Zayan M, Hussien MA, El Zahlawy H. Pars interarticularis repair using pedicle screws and laminar hooks fixation technique in patients with symptomatic lumbar spondylolysis. SICOT J. 2022;8:13. 13. Pai VS, Hodgson B, Pai V. Repair of spondylolytic defect with a cable screw reconstruction. Int Orthop. 2008;32:121-5.
14. Tang L, Wu Y, Jing D, Xu Y, Wang C, Pan J. A Bayesian network meta-analysis of 5 different fusion surgical procedures for the treatment of lumbar spondylolisthesis. Med (Baltim). 2020;99:e19639.
15. Bydon M, Alvi MA, Goyal A. Degenerative lumbar spondylolisthesis: definition, natural history, conservative management, and surgical treatment. Neurosurg Clin N Am. 2019;30:299-304.
16. Dunn AS, Baylis S, Ryan D. Chiropractic management of mechanical low back pain secondary to multiple-level lumbar spondylolysis with spondylolisthesis in a United States Marine Corps veteran: a case report. J Chiropr Med. 2009;8:125-30.
17. Boyd ED, Mundluru SN, Feldman DS. Outcome of conservative management in the treatment of symptomatic spondylolysis and Grade I spondylolisthesis. Bull Hosp Jt Dis (2013) 2019;77:172-82.
18. Nava-Bringas TI, Romero-Fierro LO, Trani-Chagoya YP, Macías-Hernández SI, García-Guerrero E, Hernández-López M, et al. Stabilization exercises versus flexion exercises in degenerative spondylolisthesis: A randomized controlled trial. Phys Ther. 2021;101:pzab108.
19. Matsunaga S, Sakou T, Morizono Y, Masuda A, Demirtas AM. Natural history of degenerative spondylolisthesis. Pathogenesis and natural course of the slippage. Spine (Phila Pa 1976). 1990;15:1204-10. 20. Eismont FJ, Norton RP, Hirsch BP. Surgical management of lumbar degenerative spondylolisthesis. J Am Acad Orthop Surg. 2014;22:203-13.
21. Mori G, Mikami Y, Arai Y, Ikeda T, Nagae M, Tonomura H, et al. Outcomes in cases of lumbar degenerative spondylolisthesis more than 5 years after treatment with minimally invasive decompression: examination of pre- and postoperative slippage, intervertebral disc changes, and clinical results. J Neurosurg Spine. 2016;24:367-74.
22. Kimura R, Yoshimoto M, Miyakoshi N, Hongo M, Kasukawa Y, Kobayashi T, et al. Comparison of posterior lumbar interbody fusion and microendoscopic muscle-preserving interlaminar decompression for degenerative lumbar spondylolisthesis with >5-year follow-up. Clin Spine Surg. 2019;32:E380-5.
23. Jang JW, Park JH, Hyun SJ, Rhim SC. Clinical outcomes and radiologic changes after microsurgical bilateral decompression by a unilateral approach in patients with lumbar spinal stenosis and Grade I degenerative spondylolisthesis with a minimum 3-year follow-up. Clin Spine Surg. 2016;29:268-71.
24. Müslüman AM, Cansever T, Yılmaz A, Çavuşoğlu H, Yüce İ, Aydın Y. Midterm outcome after a microsurgical unilateral approach for bilateral decompression of lumbar degenerative spondylolisthesis. J Neurosurg Spine. 2012;16:68-76.
25. Pazarlis K, Frost A, Försth P. Lumbar spinal stenosis with degenerative spondylolisthesis treated with decompression Alone. A cohort of 346 patients at a large spine unit. Clinical outcome, complications and subsequent surgery. Spine (Phila Pa 1976). 2022;47:470-5.
26. Ghogawala Z, Dziura J, Butler WE, Dai F, Terrin N, Magge SN, et al. Laminectomy plus Fusion versus laminectomy Alone for Lumbar spondylolisthesis. N Engl J Med. 2016;374:1424-34.
27. Tsutsumimoto T, Shimogata M, Yoshimura Y, Misawa H. Union versus nonunion after posterolateral lumbar fusion: a comparison of long-term surgical outcomes in patients with degenerative lumbar spondylolisthesis. Eur Spine J. 2008;17:1107-12.
28. Martin CR, Gruszczynski AT, Braunsfurth HA, Fallatah SM, O’Neil J, Wai EK. The surgical management of degenerative lumbar spondylolisthesis: a systematic review. Spine (Phila Pa 1976). 2007;32:1791-8.
29. Endler P, Ekman P, Möller H, Gerdhem P. Outcomes of posterolateral fusion with and without instrumentation and of interbody fusion for isthmic spondylolisthesis: A prospective study. J Bone Joint Surg Am. 2017;99:743-52.
30. Ye YP, Chen D, Xu H. The comparison of instrumented and non-instrumented fusion in the treatment of lumbar spondylolisthesis: a meta-analysis. Eur Spine J. 2014;23:1918-26..
31. Cruz A, Ropper AE, Xu DS, Bohl M, Reece EM, Winocour SJ, et al. Failure in lumbar spinal fusion and current management modalities. Semin Plast Surg. 2021;35:54-62.
32. Jalanko T, Helenius I, Remes V, Lamberg T, Tervahartiala P, Yrjönen T, et al. Operative treatment of isthmic spondylolisthesis in children: a long-term, retrospective comparative study with matched cohorts. Eur Spine J. 2011;20:766-75.
33. Voor MJ, Mehta S, Wang M, Zhang YM, Mahan J, Johnson JR. Biomechanical evaluation of posterior and anterior lumbar interbody fusion techniques. J Spinal Disord. 1998;11:328-34.
34. DiPaola CP, Molinari RW. Posterior lumbar interbody fusion. J Am Acad Orthop Surg. 2008;16:130-9.
35. Guppy KH, Royse KE, Norheim EP, Harris JE, Brara HS. PLF versus PLIF and the fate of L5-S1: analysis of operative nonunion rates among 3065 patients with lumbar fusions from a regional spine registry. Spine (Phila Pa 1976). 2021;46:E584-93.
36. Okuda S, Fujimori T, Oda T, Maeno T, Yamashita T, Matsumoto T, et al. Factors associated with patient satisfaction for PLIF: patient satisfaction analysis. Spine Surg Relat Res. 2017;1:20-6.
37. Liu X, Wang Y, Qiu G, Weng X, Yu B. A systematic review with meta-analysis of posterior interbody fusion versus posterolateral fusion in lumbar spondylolisthesis. Eur Spine J. 2014;23:43-56.
38. Kim KT, Lee SH, Lee YH, Bae SC, Suk KS. Clinical outcomes of 3 fusion methods through the posterior approach in the lumbar spine. Spine (Phila Pa 1976). 2006;31:1351-7; discussion 1358.
39. Fritzell P, Hägg O, Wessberg P, Nordwall A, Swedish Lumbar Spine Study Group. Chronic low back pain and fusion: a comparison of three surgical techniques: a prospective multicenter randomized study from the Swedish lumbar spine study group. Spine (Phila Pa 1976). 2002;27:1131-41.
40. Inamdar DN, Alagappan M, Shyam L, Devadoss S, Devadoss A. Posterior lumbar interbody fusion versus intertransverse fusion in the treatment of lumbar spondylolisthesis. J Orthop Surg (Hong Kong). 2006;14:21-6.
41. Hallett A, Huntley JS, Gibson JN. Foraminal stenosis and single-level degenerative disc disease: a randomized controlled trial comparing decompression with decompression and instrumented fusion. Spine (Phila Pa 1976). 2007;32:1375-80.
42. Fischgrund JS, Mackay M, Herkowitz HN, Brower R, Montgomery DM, Kurz LT. 1997 Volvo Award winner in clinical studies. Degenerative lumbar spondylolisthesis with spinal stenosis: a prospective, randomized study comparing decompressive laminectomy and arthrodesis with and without spinal instrumentation. Spine (Phila Pa 1976). 1997;22:2807-12.
43. Gruskay JA, Webb ML, Grauer JN. Methods of evaluating lumbar and cervical fusion. Spine J. 2014;14:531-9.
44. Li Y, Zheng LM, Zhang ZW, He CJ. The effect of smoking on the fusion rate of spinal fusion surgery: A systematic review and meta-analysis. World Neurosurg. 2021;154:e222-35.
45. Luszczyk M, Smith JS, Fischgrund JS, Ludwig SC, Sasso RC, Shaffrey CI, et al. Does smoking have an impact on fusion rate in single-level anterior cervical discectomy and fusion with allograft and rigid plate fixation? Clinical article. J Neurosurg Spine. 2013;19:527-31.
46. Cummins D, Hindoyan K, Wu HH, Theologis AA, Callahan M, Tay B, et al. Reoperation and mortality rates following elective 1 to 2 level lumbar fusion: A large state database analysis. Glob Spine J. 2022;12:1708-14.
47. Suh SP, Jo YH, Jeong HW, Choi WR, Kang CN. Outcomes of revision surgery following instrumented posterolateral fusion in degenerative lumbar spinal stenosis: A comparative analysis between pseudarthrosis and adjacent segment disease. Asian Spine J. 2017;11:463-71.
48. Derman PB, Singh K. Surgical strategies for the treatment of lumbar pseudarthrosis in degenerative spine surgery: A literature review and case study. HSS J. 2020;16:183-7.
49. Schimmel JJ, Horsting PP, de Kleuver M, Wonders G, van Limbeek J. Risk factors for deep surgical site infections after spinal fusion. Eur Spine J. 2010;19:1711-9.

Toplam 47 adet kaynakça vardır.

Ayrıntılar

Birincil Dil	İngilizce
Konular	Sağlık Bilişimi ve Bilişim Sistemleri
Bölüm	Cerrahi Tıp Bilimleri Araştırma Yazıları
Yazarlar	Hüseyin Doğu 0000-0002-7754-4984
Yayımlanma Tarihi	30 Eylül 2023
Kabul Tarihi	26 Eylül 2023
Yayımlandığı Sayı	Yıl 2023

Kaynak Göster

AMA	Doğu H. Surgical treatment of low grade lumbar spondylolisthesis. CMJ. Eylül 2023;45(3):103-111. doi:10.7197/cmj.1334716

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