Outcome of decompression and posterior fusion in spondylolisthesis

Background: Low back pain is a common cause for orthopedic consultations, with a significant proportion resulting from spondylolisthesis. Surgical management is often considered when conservative therapy fails. This study aims to evaluate the functional and radiological outcomes of decompression and posterior fusion using an H-shaped bone graft in patients with lumbar spondylolisthesis. Methods: This prospective study was conducted at the Department of Orthopedics, from 2005- 2009 in Pt. B.D. Sharma PGIMS, Rohtak. A total of 21 patients with symptomatic spondylolisthesis were included. Preoperative and postoperative assessments were performed including clinical, radiological, and functional evaluations. Patients were followed for a minimum of six months and assessed using the Herron and Trippi outcome rating system. Results: The mean preoperative VAS score was 8.04, which reduced to 2.28 postoperatively (p < 0.001). Solid fusion was achieved in 57.8% of cases. Neurological improvement was observed in most patients, with full motor and sensory recovery except in two cases. According to the Herron and Trippi scale, 66.6% had good, 23.8% had fair, and 9.5% had poor outcomes. Conclusion: Decompression and posterior fusion using an H-shaped graft is an effective, low-cost alternative to modern instrumentation for the surgical management of lumbar spondylolisthesis, particularly in resource-limited settings.