Radiological and clinical prognosis of posterior lumbar intervertebral body cage versus posterior transpedicular screw fixation in patient with isthmic spondylolisthesis

Kawa Muhammed  Kareem; Ameer Majeed  Kareem; Samih Kakamam  Hassan; Salim Mardan  Omer

doi:10.56056/amj.2025.320

Authors

Kawa Muhammed Kareem M.B.Ch. B, M.Sc. Orthopedic and Traumatology, Erbil Medical Technical Institute, Erbil Polytechnic University, Erbil – Iraq
Ameer Majeed Kareem M.B.Ch. B, F.I.C.M.S. (Neurosurgery), Kurdistan Ministry of Health, Erbil Health Department, Erbil Teaching Hospital, Erbil Iraq
Samih Kakamam Hassan M.B.Ch. B, M.Sc. Orthopedic and Traumatology, Erbil Health Technical College, Erbil Polytechnic University, Erbil – Iraq
Salim Mardan Omer B.Ch. B, F.I.C.M.S. (Neurosurgery), Ministry of Higher Education and Scientific Research, Kirkuk University / College of Medicine, Kirkuk, Iraq

DOI:

https://doi.org/10.56056/amj.2025.320

Keywords:

Posterior Intervertebral Body Fusion, Spinal Fusion, Spondylolisthesis, Transpedicular Screw

Abstract

Background and objectives: Isthmic type of Spondylolisthesis, resulting from the failure of the anterior column, requires fixation by a transpedicular screw posteriorly. The research aimed to distinguish discrepancies in clinical presentation, functional outcomes, and mechanical characteristics by evaluating clinical, radiographic, activity, and pain information.

Methods: A Prospective study was conducted from January 2016 until March 2020, at Erbil Teaching and Paky Hospital, Pedicle screw fixation was performed on 70 consecutive patients diagnosed with isthmic spondylolisthesis. Posterior transpedicular screw fixation was performed in 36 persons, while posterior lumbar intervertebral body fusion was performed in 34 persons. The assessments of the activity and pain statuses were performed prior to and post the surgical procedure.

Results: There was no statistically significant divergence of the modifications. The statistical analysis conducted within the groups has demonstrated that the surgery had a significant impact on the subluxation percentage, angle of slippage, and foraminal area. Nevertheless, it had no impact on the sacral inclination or the segmental lordosis. The 3-year follow-up examination did not demonstrate any statistical intergroup differences regarding improvement neurologically (p=1.01), Activity outcome (p=0.52), Pain outcome (p=0.87), fusion rate (p=0.47). Nonetheless, the group that underwent PLIF procedure showed maintained subluxation correction, disc height, and foraminal area which was not observed in the fusion by only posterolateral approach group (p_0.07).

Conclusion: The interbody fusion procedure provides enhanced mechanical strength to the spinal structure in instances of Isthmic spondylolisthesis. It is anticipated that the degree of correction attained will slowly decrease when posterior transpedicular fixation clinically.

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