Spondylolisthesis reduction and transforaminal interbody fusion with bone morphogenic protein: A new technique and 2 year follow-up
This study reports clinical and radiographic results using a new technique to both reduce low grade spondylolisthesis and perform TLIF with a cage and BMP.
Sixty-nine patients with spinal stenosis and low grade degenerative or isthmic spondylolisthesis were surgically treated by one surgeon, followed 3 yrs (24-57 mo). Screws with a pivoting reduction post were used to reduce the spondylolisthesis to a single contralateral rod. Autograft TLIF with a cage was used prior to ipsilateral rod placement. Interbody BMP-2 sponges were used outside the cage in 28.
Two nonunions (non-rhBMP-2), 3 infections, 1 PE, and no deficits occurred. Four required additional surgery for adjacent stenosis and fusion. Improvement in Oswestry (47-27) and VAS (7-2), pain medication use was seen.
In low grade spondylolisthesis, the slip can be reduced and the cage and BMP TLIF done. Reliable arthrodesis and clinical results can be expected with few complications using this new technique.