Complications in spondylolisthesis surgery.

STUDY
DESIGN: Selected references are cited to illustrate the current status of approaches to surgical complications in isthmic spondylolisthesis surgery.
OBJECTIVE: To minimize untoward events and outcomes in the surgical treatment of spondylolisthesis, an awareness of complications and pitfalls specific to spondylolisthesis surgery is necessary. SUMMARY OF BACKGROUND DATA: Pseudarthrosis is the most common complication, and factors that contribute are vertebral geometry, bone grafting options and technique, and immobilization with instrumentation constructs or an orthosis. There has been an increase in neurologic deficits associated with spondylolisthesis surgery during the period of 1996 to 2002. Neurologic sequelae can include cauda equina syndrome, root lesions, autonomic dysfunction, and chronic pain. These can result from reduction maneuvers, instrumentation, and after surgery, although neurologic deficit can occur without identifiable causes. Restoring or maintaining the physiologic sagittal contour of the lumbar spine is a necessary component of surgical planning.
METHODS: Literature review.
RESULTS: Problems and complications associated with the surgical treatment of spondylolisthesis are well documented in the medical literature.
CONCLUSIONS: The occurrence of pseudarthrosis, neurologic deficits, and transition syndromes such as spondylolisthesis acquisita, S1-S2 deformity, and adjacent segment syndrome can be minimized with proper planning and attention to surgical technique.