Purpose: To assess if the evaluation of the spino-pelvic balance can be effective in the surgical decision making of the high-grade high dysplastic developmental spondylolisthesis (HDDS).

Methods: Sixteen patients affected with high-grade HDDS (6 treated with "in situ" fusion, and 10 with reduction and fusion) were retrospectively evaluated. A clinical and radiological assessment of the deformity correction was carried out, with a minimum follow-up of 2 years. The differences between the pre- and postoperative measures were statistically analyzed using a two-tailed, paired t test.

Results: The six patients treated with "in situ" fusion showed no statistically significant change at the last follow-up relative to pelvic tilt (PT), sacral slope (SS), and grade, while the 10 patients treated with reduction showed significant changes: PT significantly decreased following surgery, while SS and grade significantly increased.

Conclusions: The analysis of the spino-pelvic sagittal balance allows to identify two types of HDDS: the balanced deformities, which do not need reduction, and the unbalanced deformities, in which correction is needed.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3325395PMC
http://dx.doi.org/10.1007/s00586-012-2230-2DOI Listing

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