Treatment of lumbar lytic spondylolisthesis using osteoperiosteal transplants in young patients.

A series of 40 young patients with lumbar spondylolisthesis is presented. The patients were treated surgically using osteoperiosteal transplants as the fusion material. In 29 patients, the fusion was posterior and in 11 patients posterolateral. The loose posterior element was removed in eight patients in connection with fusion. The degree of slipping on admission was less than 30% in 18 patients (45%), 30 to 50% in 5 patients (12.5%), and more than half of the olisthetic vertebral body in 17 patients (42.5%). A good clinical result was obtained in 24 patients (60%), satisfactory in 11 (27.5%), and poor in 5 (12.5%). Solid union was obtained in 29 patients (72.5%), nonunion in 7 cases (17.5%), and in 4 patients (10%) the union was considered uncertain. One patient was reoperated on. The best results were obtained using posterior fusion, while the rate of nonunion was higher in the posterolateral group. The periosteum was taken from the anteromedial aspect of the tibia using a sharp chisel. The method gives clinical and radiological results comparable with those obtained using bone transplants.