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IN-SITU FIXATION OF SEVERE L5-S1 SPONDYLOLISTHESIS. USING TRANS SACRAL SCREWS.



Abstract

Purpose: To assess the results of this technique for stabilisation of severe spondylolisthesis.

Method: Twelve patients with symptomatic severe spondylolisthesis were treated with this technique. All the patients had significant symptoms, inspite of conservative measures. The mean duration of symptoms was 3.5 years. The fixation technique was purely done through a posterior approach, with extensive posterior decompression. Stabilisation of the slipped L5 vertebra was achieved with a trans sacral screw. The point of entry of the screw being the posterior part of the body of S1 and it traverses the L5-S1 disc space into the L5 body. A hollow medullary screw passed over a guide wire helps achieve the fixation. This fixation is supplemented with pedicle screws into L5 and S1 and posterolateral bone grafting. Thus an anterior and posterior fusion was achieved and the severe slip fixed in-situ.

Results: The mean follow-up was 1 year. All but one (8%) patient had improvement in leg pain. 2(16%) patients were aware of the prominent metalwork (pedicle screws). Good 360° fusion was achieved using this technique in all the patients. There was no progression of spondylolisthesis.

Conclusion: Thus, anterior and posterior in-situ fusion for severe L5-S1 spondylolisthesis can be achieved effectively using a single incision via a transsacral approach.

Abstracts prepared by Mr. A. J. Stirling, FRCS, and Miss A. Weaver. Correspondence should be addressed to Miss A. Weaver at the Research and Teaching Centre, Royal Orthopaedic Hospital, Northfield, Birmingham, B31 2AP, UK

BritSpine 2002, the second combined meeting of the British Association of Spinal Surgeons, the British Cervical Spine Society, The British Scoliosis Society and the Society for Back Pain Research, took place at the International Convention Centre in Birmingham UK between 27th February and 1st March 2002. The following presentations and posters were given and displayed.