Daniela Linhares1,2, Pedro Cacho Rodrigues3, Manuel Ribeiro da Silva4,5, Rui Matos4, Vitorino Veludo4, Rui Pinto6, Nuno Neves4,5. 1. Orthopedics Department, Centro Hospitalar São João, Porto, Portugal. Daniela_linhares@sapo.pt. 2. MEDCIDS - Faculty of Medicine, University of Porto, Porto, Portugal. Daniela_linhares@sapo.pt. 3. Orthopedics Department, Hospital da Prelada, Porto, Portugal. 4. Orthopedics Department, Centro Hospitalar São João, Porto, Portugal. 5. Orthopedics - Faculty of Medicine, University of Porto, Porto, Portugal. 6. Orthopedics Department, Hospital Santa Maria, Porto, Portugal.
Abstract
PURPOSE: To describe and analyze the use of the V-rod technique described by Gillet to repair spondylolysis in both early and late postoperative periods. METHODS: Patients submitted to surgical correction of lumbar spondylolysis with a V-rod system were selected upon exclusion of adjacent disk degenerative changes and high-grade spondylolisthesis. A preoperative clinical (ODI and VAS) and radiological evaluation was performed, along with assessments on the early (clinical evaluation-up to 1 year) and late (clinical and radiological-at least 10 years) postoperative periods. RESULTS: Twenty-two patients were included, 21 with L5 spondylolysis. Fifty percent had grade I spondylolisthesis. A significant decrease in ODI and VAS was observed from pre- to early and late post-op evaluation (all p < 0.05) but not during post-op evaluations. Changes from pre- to postoperative of both ODI and VAS were significantly higher than the minimal clinically important difference. Preoperative ODI and VAS were significantly higher in overweight/obese but similar postoperatively. No additional instability was found in late postoperative X-rays. Three patients needed revision surgery, with a survival rate of 81.8% for Gillet instrumentation at a mean follow-up of 687.7 ± 60.0 weeks. CONCLUSIONS: Surgical treatment with V-rod system is associated with a significant improvement in ODI and VAS and radiologic stability, with an equal benefit in obese/overweight patients. This study reports for the first time an improvement that is maintained even 10 years after the initial intervention, associated with a low rate of failure. These slides can be retrieved under Electronic Supplementary Material.
PURPOSE: To describe and analyze the use of the V-rod technique described by Gillet to repair spondylolysis in both early and late postoperative periods. METHODS:Patients submitted to surgical correction of lumbar spondylolysis with a V-rod system were selected upon exclusion of adjacent disk degenerative changes and high-grade spondylolisthesis. A preoperative clinical (ODI and VAS) and radiological evaluation was performed, along with assessments on the early (clinical evaluation-up to 1 year) and late (clinical and radiological-at least 10 years) postoperative periods. RESULTS: Twenty-two patients were included, 21 with L5 spondylolysis. Fifty percent had grade I spondylolisthesis. A significant decrease in ODI and VAS was observed from pre- to early and late post-op evaluation (all p < 0.05) but not during post-op evaluations. Changes from pre- to postoperative of both ODI and VAS were significantly higher than the minimal clinically important difference. Preoperative ODI and VAS were significantly higher in overweight/obese but similar postoperatively. No additional instability was found in late postoperative X-rays. Three patients needed revision surgery, with a survival rate of 81.8% for Gillet instrumentation at a mean follow-up of 687.7 ± 60.0 weeks. CONCLUSIONS: Surgical treatment with V-rod system is associated with a significant improvement in ODI and VAS and radiologic stability, with an equal benefit in obese/overweight patients. This study reports for the first time an improvement that is maintained even 10 years after the initial intervention, associated with a low rate of failure. These slides can be retrieved under Electronic Supplementary Material.
Entities:
Keywords:
Lumbar back pain; Lumbar vertebrae; Spondylolisthesis; Spondylolysis; V-rod technique
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