Evaluation of functional outcomes of lumbar and lumbosacral isthmic and degenerative spondylolisthesis treated surgically

Abstract Background Spondylolisthesis (SPL) is defined as the displacement of the vertebral body of a lumbar vertebra relative to the overlying or underlying vertebra. Purpose To describe the epidemiological, clinical, radiological, therapeutic, and evolutionary aspects of patients presenting to our clinic with SPL, and to review the current litterature related to management of SPL, to review the role the imaging in establishing the diagnosis and to review choice the therapeutic modalities, including various surgical techniques, and finally, to assess the functionnel outcomes of these patients. Patients and methods From January 2012 to December 2017 we performed a retrospective review on a series of 34 patients undergoing surgery for SPL in the neurosurgery department of the Habib Bourguiba University hospital center in Sfax (Tunisia). The operative technique was tailored for each patient individually and consisted of lumbar decompression, posterior lumbar fusion (PLF) or posterior lumbar interbody fusion (PLIF). We adopted the Witzel criteria to assess the post-operative outcomes of patients. Results The mean age of the patients was 49.5 years. Neurological examination was normal in 18 patients (52.9%). The mean duration of symptoms was 24 months. We did not find significant association between the degree of slippage according to Meyrding classification and impaired neurological examination (p=0.67). Laminectomy and spino-lamino-arthrectomy were performed in 27 patients (79.4%). Five patients underwent PLIF (15.1%), 15 patients underwent PLF (45.4%), 1 patient underwent lateral arthrodesis (3.1%) and 12 patients didn’t underwent arthrodesis (36, 4%). Postoperative functional results were independent of age, type of SPL, Meyrding grade, neurological decompression, type of arthrodesis, and use of instrumentation. Conclusion We have presented our diagnostic and surgical experience for managing patients with SPL in a developing country.