Spondylolisthesis
Spondylolisthesis is the anterior slippage of a vertebra above another, meaning instability.
It may be due to an isthmic lysis, or to a degenerative disc.
It can be responsible for low back pain, and eventually radicular pain (sciatica).
The surgical treatment aims to stabilize the segment by performing a fusion.
Fusion through posterior approach
Arthrodesis is the fusion between two or more vertebra.
Through a posterior approach:
- Instrumentation is performed with pedicular screws, linked by a rod.
- Nerve roots and dural sac are released accordingly.
- An intervertebral cage, and bone graft may be inserted through the posterior part of the disc.
- Posterior elements are prepared with chisels, and bone graft is applied.
Fusion through anterior approach
Arthrodesis is the fusion between two or more vertebra.
When performed through an anterior approach, the intervertebral disc is removed from the front.
Careful preparation of the vertebral endplates, and posterior release of the longitudinal ligaments are done before the implant is inserted.
An intervertebral device called a “cage” is placed between the two vertebra along with a bone graft.
The anterior approach spares the posterior spinal muscles, allows for a greater bone graft, and a better height and lordosis restauration.
Preoperative
Postoperative
Anterior surgery for spondylolisthesis
Step by step
Fusion through lateral approach
Arthrodesis is the fusion between two or more vertebra.
When performed through a lateral approach, the intervertebral disc is removed from the side.
An intervertebral body device called a “cage” is placed between the two vertebra along with a bone graft.
The lateral allows for a greater bone graft, and spares the posterior spinal muscles.
