OBJECTIVE: The treatment of high-grade lumbosacral spondylolisthesis (grade IV and spondyloptosis) includes the reduction of the displacement if possible, decompression, fixation and arthodesis of the affected level. This disease causes severe level of disability and a postural lumbosacral deformity, leading the patients to assume anodyne gait with a chronic contraction of the hamstrings. This technique performed solely by posterior approach aims to provide clinical improvement, reduce surgical time and morbidity. METHODS: The authors describe a technique to decompress and fix the lumbosacral spine by trans pedicular instrumentation in L4 and S1, discectomy and TLIF (Transforaminal Lumbar Interbody Fusion) in L4-L5, laminectomy at levels L4-L5, L5-S1, S1-S2, posterior-anterior fusion from S1 to L5 for tunneling through both vertebral bodies and a fibular bone graft.The authors retrospectively reviewed nine patients who underwent this technique between 2000 and 2010. All patients were assessed and followed for 12 months on average after surgery. RESULTS: The mechanical and radicular symptoms improved in the follow-up period in the short and long term. Radiological studies showed adequate bone fusion in all patients. There were no instrumentation-related failures. CONCLUSIONS: The authors claim that this technique is safe and effective for decompression and posterior fixation in situ without sagittal correction. This technique prevents access by the anterior or combined approaches and reduce bleeding, morbidity and high costs.
Spondylolisthesis; Spinal fusion; Postural balance; Low back pain; Arthrodesis
