Objective: Posterior Interbody fusion can be associated to adjacent segment disease (ASD) some years after surgery. The aim of this study is to confirm the rate of ASD in isthmic spondylolisthesis treated by posterior fusion.
Methods: Patients treated by posterior lumbar fusion were collected between January 2014 to June 2022. Inclusion criteria encompassed adults diagnosed with isthmic spondylolisthesis and available preoperative, postoperative, and FU radiological images.
Results: Out of the 140 patients included in the study, the majority were female (53.6%) with a mean age of 48.5 years. In 111 (79.3%) patients the spondylolisthesis was located at L5-S1; in 20 (14.3%) patients at L4-L5; 5 (3.6%) cases presented the defect at L4-L5-S1, and in 4 (2.8%) cases at L3-L4. In 75 (53.6%) patients, the listhesis was classified as Grade I (Meyerding); in 50 (35.7%) cases as Grade II; in 12 (8.6%) cases as Grade III; and in 3 (2.1%) cases as Grade IV. The average follow-up of this study was 67 (10-111) months. Two cases (1.43%, 95% CI: 0.17%-5.07%) of ASD were observed. Evaluations of clinical symptoms revealed a notable reduction in the average Numeric Rating Scale (NRS) score from 8 to 1.9 at the last follow-up. Postoperative PI-LL mismatch < 10 correlating with a favorable outcome (NRS ≤ 3).
Conclusions: This study confirms data already present in the literature regarding the low incidence of ASD in patients who underwent surgery for isthmic spondylolisthesis. The posterior approach seems to remain a safe and effective technique in these patients.
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