Posterior lumbar interbody fusion with single cage and bonegraft substitute for the management of spondylolisthesis: A prospective study

Posterior lumbar interbody fusion with single cage and bonegraft substitute for the management of spondylolisthesis: A prospective study - Purpose: Posterior lumbar interbody fusion (PLIF) is one of the surgical treatment options for spondylolisthesis. We assess the results of spondylolisthesis treated by PLIF with single cage and bone graft substitute (calcium phosphate granules of master graft, MEDTRONICS) in terms of radiological union, relief of previous symptoms like back pain & radiating pain and return to daily activities. Materials and Methods: A total of 30 patients were studied from December 2017 to January 2022, out of which 09 were male and 21 were female. The range of age between 40 to 60 years was included in this prospective study. All patients were followed-up for a period of 5 years. Eighteen (60%) patients had degenerative spondylolisthesis, 12 (40%) had isthemic spondylolisthesis. According to Meyerding criteria there were 19(63.33%) cases of grade II, 11 (36.66%) cases of grade III spondylolisthesis. Results: Clinical score assessed by Oswestry low back pain disability questionnaire, Prolo score and VAS score. Oswestry disability index score improved from mean value of 29.33 points to 9.63 points, Prolo score improved from mean of 3.2 to 8.3 and VAS score improved from mean value of 8.42 to 1.14 at 5 years follow-up period. The radiological assessment of the intervertebral disc height, pre-operatively it was 16.93 (mean) and at follow up it was 24.64. Clinical assessment shows excellent results in 7 patients (23.33%), 20 patients (66.66%) got good results, 3 patients (10%) belonged to the fair group. 93.33% of radiological spinal fusion observed in this study according to Stauffer and Coventry criteria. Conclusion: Posterior lumbar interbody fusion (PLIF) with single titanium cage and bone graft substitute (calcium phosphate granules of master-graft, MEDTRONICS) is a better method in the treatment of spondylolisthesis because it provides a good spinal fusion, minimal surgical time and fewer complications with satisfactory clinical outcome. Level of evidence: Level IV, therapeutic case series. Keywords: Spondylolisthesis, Posterior lumbar interbody fusion, Single cage and bone graft substitute, Spinal instrumentation.