A study on management of high grade spondylolisthesis

Background: Spondylolisthesis is defined as a displacement of one vertebra over the next lower vertebra in the sagittal plane. High-grade spondylolisthesis (HGS) is defined as greater than 50% slippage of a spinal vertebral body relative to an adjacent vertebral body as per Meyerding classification, and most common location being L5/S1 followed by L4/L5. The treatment of symptomatic high grade lumbo sacral spondylolisthesis has its own technical difficulties for surgical stabilization and fusion unlike low grade listhesis. We used single transvertebral fibular graft and implant stabilization to the vertebra one level above the pathological vertebra via posterior approach to treat the high grade spondylolisthesis of lumbo sacral spine. Materials and methods: Prospective study done from January 2012 to January 2016 for the management of High grade spondylolisthesis (Grade 3 and Grade 4), patient aged between 15-60 years. Total 15 patients were included in the study. High grade listhesis patients who were not willing for surgery were excluded from the study. All the patients were operated posteriorly with pedicle screw and rod stabilization with trans vertebral single fibular graft with posterolateral fusion was done under fluoroscopic guidance Results: Preoperative and post-operative status was analyzed in reference to the clinical symptoms and radiological evaluation. All the patients showed improvement following surgery without any implant failure. Conclusion: This procedure is technically simple, safe and effective method to treat high grade listhesis with no additional peri operative or postoperative complications.