STUDY DESIGN: : Literature review. OBJECTIVES: : The purpose of this article is to review the available literature and to attempt to formulate evidence-based recommendations for the surgical treatment of high-grade spondylolisthesis in the pediatric population. SUMMARY OF BACKGROUND DATA: : The surgical management of high-grade spondylolisthesis remains controversial due to the lack of high level evidence. Prospective randomized studies have not been completed. METHODS: : Through an electronic database search and published literature cross-reference, appropriate studies were identified and assigned the appropriate level of evidence. RESULTS: : There were no Level I or II evidence on this topic with our search. The best level of evidence that we have on this topic is retrospective comparative studies. We found 5 such articles which compared fusion in situ to reduction and fusion for high-grade spondylolisthesis. Pseudarthrosis rates are decreased by performing an instrumented reduction with a fusion. However, there is no significant difference in a clinical outcome of patients treated in situ versus reduction. CONCLUSION: : Because of the paucity of high levels of evidence, we are not able to formulate clear guidelines for treatment of high-grade spondylolisthesis based on the best evidence available in the published literature.
STUDY DESIGN: : Literature review. OBJECTIVES: : The purpose of this article is to review the available literature and to attempt to formulate evidence-based recommendations for the surgical treatment of high-grade spondylolisthesis in the pediatric population. SUMMARY OF BACKGROUND DATA: : The surgical management of high-grade spondylolisthesis remains controversial due to the lack of high level evidence. Prospective randomized studies have not been completed. METHODS: : Through an electronic database search and published literature cross-reference, appropriate studies were identified and assigned the appropriate level of evidence. RESULTS: : There were no Level I or II evidence on this topic with our search. The best level of evidence that we have on this topic is retrospective comparative studies. We found 5 such articles which compared fusion in situ to reduction and fusion for high-grade spondylolisthesis. Pseudarthrosis rates are decreased by performing an instrumented reduction with a fusion. However, there is no significant difference in a clinical outcome of patients treated in situ versus reduction. CONCLUSION: : Because of the paucity of high levels of evidence, we are not able to formulate clear guidelines for treatment of high-grade spondylolisthesis based on the best evidence available in the published literature.
Authors: Wilco C H Jacobs; Sidney M Rubinstein; Paul C Willems; Wouter A Moojen; Ferran Pellisé; Cumhur F Oner; Wilco C Peul; Maurits W van Tulder Journal: Eur Spine J Date: 2013-05-17 Impact factor: 3.134
Authors: Peter G Passias; Caroline E Poorman; Sun Yang; Anthony J Boniello; Cyrus M Jalai; Nancy Worley; Virginie Lafage Journal: Int J Spine Surg Date: 2015-10-01
Authors: Angel E Macagno; Saqib Hasan; Cyrus M Jalai; Nancy Worley; Alexandre B de Moura; Jeffrey Spivak; John A Bendo; Peter G Passias Journal: J Orthop Date: 2016-01-22