The influence of complete vertebra reduction on the development of neurological com- plications after surgical treatment for the L5 spondylolytic spondylolisthesis with high degree of dislocation

Abstract

Objective. To perform retrospective analysis of the dynamics of neurological symptoms following complete reduction of the L5 vertebra in groups of patients with low-grade (I–II) and high-grade (III–V, ptosis) L5 spondylolytic spondylolisthesis. Material and Methods. Thе study included 158 patients who underwent surgical treatment for the L5 spondylolytic spondylolisthesis. Results. A pronounced positive dynamics was observed in the postoperative period after using the same surgical tactics in the treatment of both low- and high-degree spondylolisthesis. In isthmic spondylolisthesis, regression of pain syndrome and neurological deficit was longer in patients with high-grade spondylolisthesis in the early postoperative period. At 6 month and 1 year follow-up examination, there was no reliable difference between low- and high-grade spondylolisthesis. Conclusion. The complete reduction of the L5 vertebra does not significantly impair the patient’s neurological status. The complete reduction of the displaced vertebra and the correction of the lumbar spine can predict the restoration of the sagittal balance with respect to the lumbar lordosis angle and the pelvic tilt, which results in restoration of the patient’s ability to work and early social adaptation.

Keywords

• spondylolytic spondylolisthesis
• neurological complications
• l5 reduction