Spondylolisthesis Surgery - Fusion and Stabilisation

The goal in spondylolisthesis surgery is the stabilisation of the slippage, nerve decompression, and, when necessary, the correction of the slippage (reduction).

Surgical Techniques

PLIF/TLIF: Posterior or transforaminal lumbar interbody fusion are the most frequently performed techniques. A cage is placed into the disc space, and stabilisation is achieved with transpedicular screws. TLIF reduces the need for retraction with a unilateral approach.¹

ALIF: Interbody fusion performed with an anterior approach provides extensive disc height restoration and lordosis correction, especially at the L5-S1 level.^2,3

Reduction

In Grade II and higher slippages, partial or complete correction of the slippage (reduction) is controversial. Correction improves sagittal balance and provides favourable conditions for fusion.⁴ Intraoperative neuromonitoring is used to reduce this risk.⁵

ALIF: Interbody fusion performed with an anterior approach provides extensive disc height restoration and lordosis correction, especially at the L5-S1 level.

Outcomes

Pain relief in spondylolisthesis surgery is at a rate of 80-90 percent. The fusion rate can reach up to 96 percent with modern instrumentation.^6,7 The most important determinants of surgical success are the correct indication, appropriate technique selection, and the patient's general health status.

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