SURGICAL MANAGEMENT OF SPONDYLOPTOSIS - SHORT TERM FOLLOW UP

Abstract

Spondylolisthesis forward translation of one   segment of the spine upon another. Grade V   spondylolisthesis is called spondyloptosis according to  meyerding classification.29years female presented with pain in her low back 1 year. It was chronic dull aching pain with numbness in left lower foot without history of motor weakness. According to Meyerding system of grading, the slip was grade V in our patient. Spectrum of available surgical option include instrumented in situ fusion, instrumented  reduction and fusion, uninstruemented in situ fusion which may be postero-lateral, anterior or circumferential bony fusion and vertebrectomy (GAINES PROCEEDURE). We done  fusion in situ with posterior instrumentation with  decompression. Post-operative period is uneventful. The patient was followed 1, 3, 6th month than periodically for 3 years. In follow up the patient did not have rest pain. Patient can walk for longer distance, No motor weakness, and   Sensory blunting S1 in left foot has recovered. In this case the follow up CT scan revealed the fusion in spondyloptosis           segment. In our case ODI (Osweltry Disability Index)(to see functional outcome) has 6 which indicates good functional outcome. Decompression, in situ fusion with posterior             instrumentation is a safer method in managing high grade spondylolisthesis and had given good functional outcome.