Advantages And Disadvantages Of Interbody Fusion

9. Discussion

There are different types of surgical method or techniques that have been developed in past years to achieve fusion and reduction for the deformity of isthmic spondylolisthesis, [52, 53, 59-62] but it is difficult to define the ideal surgical strategy for IS in adults based on the published data [65]. Each procedure has its own advantages and disadvantages; the basic principle of surgical treatment is decompression and stabilization. In various studies, some Surgeon [65, 66, 67] showed that in case of severe spondylolisthesis, it is better to fuse in situ then reduction procedure in the long bone. However, for slipped vertebrae extended at one or two level, usually fusion in situ is performed [65, 66, 68]. De Wald et al. [69]

Interbody fusion is a common and accepted surgical approach to treat spondylolisthesis. The main advantage of the interbody fusion is nerve root decompression, slip reduction, and posterolateral stabilization can all be performed through a single posterior incision. This procedure was found to have significantly fewer complications, anterior interbody support, posterolateral stabilization, visualization and exiting nerve roots decompression, reduction of the anterolisthesis shorter operating room times, shorter duration of hospital stays, less blood loss, and lower overall costs. [63, 64] Given these considerations, it would seem that the PLIF/TLIF is, in many ways, an ideal procedure for isthmic

In addition, the patient's hospital stay can be reduced, with quicker rehabilitation to ambulatory status. Thus, the overall cost of treatment may be reduced by the single-stage procedure. Similar results are reported by Louis [74], who compared the single-stage posterior procedure (78% satisfactory results) with combined anterior/posterior lumbosacral fusions (79% satisfactory results). In addition, the introduction of transpedicular fixation devices [75, 78-84] allows a reduction in the number of fused segments, especially in cases of spondylolysis and spondylolisthesis. The saving of healthy segments seems to be a distinct advantage compared to the "long rod technique." With cantilever systems such as the internal fixator [76, 77, 81, 82, 84, 85] or with unsatisfactory outcome were treated because of failed treatment for back syndrome (five patients) and deformity after fracture (two