Isfahan University of Medical Sciences

Science Communicator Platform

Stay connected! Follow us on X network (Twitter):
Share this content! On (X network) By
A Comparative Study of L4-L5-S1 and L5-S1 Vertebral Fusion in High-Grade L5-S1 Spondylolisthesis Publisher



Rezvani M1 ; Sabouri M2 ; Mahmoodkhani M3 ; Mokhtari A4 ; Tehrani DS5
Authors
Show Affiliations
Authors Affiliations
  1. 1. Department of Neurosurgery, School of Medicine, Neurosciences Research Center, Al-Zahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
  2. 2. Department of Neurosurgery, School of Medicine, Medical Image and Signal Processing Research Center, Al-Zahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
  3. 3. Department of Neurosurgery, School of Medicine, Neurosciences Research Center, Kashani Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
  4. 4. Department of Neurosurgery, Isfahan University of Medical Sciences, Isfahan, Iran
  5. 5. Department of It, Shahid Beheshti University, Tehran, Iran

Source: Journal of Craniovertebral Junction and Spine Published:2021


Abstract

Introduction: One of the most common types of spinal diseases is spondylolisthesis, which in advanced cases requires surgical intervention. This study aimed to compare the results of L4-L5-S1 and L5-S1 vertebral fusion treatment in high-grade L5-S1 spondylolisthesis. Methods: A study design that randomized controlled trial. A total of 70 consecutive patients who underwent surgery for the treatment of spondylolisthesis at Al-Zahra Hospital in Isfahan, Iran, were evaluated from July 2020 to February 2021 (35 patients underwent L4-L5-S1 and 35 received L5-S1 vertebral fusion treatment). The radicular and low back pain (LBP) intensity (Vanguard Australian Shares), blood loss, wound infection, reduction, and quality of life (SF-12 scores) were quantified before the surgery, 1, 3, and 6 months after surgery in two groups. Results: Patients involved in the two groups had similar baseline demographic characteristics. The percent slip in L4-L5-S1 and L5-S1 group, respectively, postoperative 81.11% and 57.89%, P = 0.0001. Intraoperative blood loss and postoperative were higher in the L4-L5-S1 group when compared to the L5-S1 group (P < 0.05). The wound infection rate of the L4-L5-S1 group was similar to that of the L5-S1 group (8.6% vs. 2.9%, P = 0.303). There was no difference in radicular and LBP intensity, SF-12 scores among patients with L4-L5-S1 and L5-S1 groups (P < 0.05). Conclusion: Both L4-L5-S1 and L5-S1 were equally beneficial in improving short-term functional outcomes for patients with high grade L5-S1 spondylolisthesis. However, L4-L5-S1 was associated with statistically significant higher incidences of blood loss, but it was accompanied by a better reduction. Therefore, caution should be exercised when considering L4-L5-S1. © 2021 Wolters Kluwer Medknow Publications. All rights reserved.
Related Docs
View other Related Docs
1. Posterolateral Instrumented Fusion With and Without Transforaminal Lumbar Interbody Fusion for the Treatment of Adult Isthmic Spondylolisthesis: A Randomized Clinical Trial With 2-Year Follow-Up, Journal of Craniovertebral Junction and Spine (2016)
2. Comparison of 1-Stage Versus 2-Stage Decompression, Fusion and Instrumentation Surgery in Patients With Coexisting Cervical and Lumbar Degenerative Spondylotic Disorders; a Prospective, Randomized, Controlled Clinical Trial Study, Journal of Isfahan Medical School (2016)
3. Spondylodiscitis Instrumented Fusion, a Prospective Case Series on a Standardized Neurosurgical Protocol With Long Term Follow Up, Injury (2024)
4. Autograft and Allograft Bone Chips Interbody Fusion for Spondylodiscitis: Surgery Outcomes, Caspian Journal of Internal Medicine (2023)
5. Value of Spinal Infection Treatment Evaluation Score, Pola Classification, and Brighton Spondylodiscitis Score From Decision to Surgery in Patients With Spondylodiscitis: A Receiveroperating Characteristic Curve Analysis, Asian Spine Journal (2024)
6. Evaluating of the Results of Long Fusion Surgery in Patients With Degenerative Lumbar Scoliosis, Tehran University Medical Journal (2021)
7. In-Fracture Pedicular Screw Placement During Ligamentotaxis Following Traumatic Spine Injuries, a Randomized Clinical Trial on Outcomes, Korean Journal of Neurotrauma (2023)
8. Comparison of Open Surgical Discectomy Versus Plasma-Laser Nucleoplasty in Patients With Single Lumbar Disc Herniation, Journal of Research in Medical Sciences (2015)
Experts (# of related papers)
View all Related Experts
Majid Rezvani (11)
Mehdi Mahmoodkhani (5)
Other Related Docs
9. Evaluation of Treatment Results of Posterior Approach Surgery in Patients With Cervical Spondylotic Myelopathy, Journal of Babol University of Medical Sciences (2020)
10. Effect of High-Dose Intravenous Dexamethasone on Postlumbar Discectomy Pain, Spine (2006)
11. Investigation of Functional Disability, Psychological Status, and Quality of Life of Patients Undergoing Lumbar Disc Surgery, Journal of Military Medicine (2023)
12. Effects of Perioperative Use of Two Doses of Magnesium Sulfate Infusion on Intraoperative Blood Loss in Patients Undergoing Lumbar Spinal Fusion Surgery, Journal of Emergency Practice and Trauma (2023)
13. Lumbosacral Transitional Vertebra in Spondylolisthesis: Frequency, Demographic Findings, and Clinical Characteristics, BMC Musculoskeletal Disorders (2024)
14. Prevalence and Incidence of Early and Late Complications of Lumbar Spine Fusion Surgery in Alzahra and Kashani Hospitals in Isfahan City, Iran, During 2011-2015, Journal of Isfahan Medical School (2016)
15. Lumbar Sacralization and L4-L5 Microdiscectomy, a Prospective Cohort Study on Radiologic and Clinical Outcomes, World Neurosurgery: X (2024)
16. Postoperative Complications of Posterior Fusion With Instrumentation in Adult Patients With Idiopathic Scoliosis, Journal of Isfahan Medical School (2017)
17. The Effectiveness of Computed Tomography Scans Versus Magnetic Resonance Imaging for Decision Making in Patients With Low Back Pain and Radicular Leg Pain, Journal of Research in Medical Sciences (2006)
18. Rehabilitation in Subjects With Chronic Non-Specific Low Back Pain With Sacroiliac Joint Origin: Protocol for a Systematic Review, Muscles, Ligaments and Tendons Journal (2020)
19. Analgesic Effects of Ketamine Infusion on Postoperative Pain After Fusion and Instrumentation of the Lumbar Spine: A Prospective Randomized Clinical Trial., Medicinski arhiv (2012)
20. Comparison of the Therapeutic Effect of Proximal Row Carpectomy and Midcarpal Artherodesis in Patients With Scaphoid Fracture and Dislocation, Journal of Isfahan Medical School (2019)
21. Comparison of Scheuermann’S Kyphosis Correction by Combined Anterior–Posterior Fusion Versus Posterior-Only Procedure, European Spine Journal (2016)
22. Thoracolumbar Junction Fracture and Long Instrumented Fusion, a Trial on a Standardized Surgical Technique With Long Term Clinical Outcomes, Interdisciplinary Neurosurgery: Advanced Techniques and Case Management (2024)
23. Effectiveness of Transforaminal Steroid Injections in Spinal Canal Stenosis Grade 1 to 3, Interdisciplinary Neurosurgery: Advanced Techniques and Case Management (2024)
24. The Effect of Age on Result of Straight Leg Raising Test in Patients Suffering Lumbar Disc Herniation and Sciatica, Journal of Research in Medical Sciences (2015)
25. The Quality of Life of 50-70 Years Old Patients With Orthopedic Spinal Stenosis Surgery. a Follow-Up Study (Descriptive Study), Caspian Journal of Internal Medicine (2023)