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Safety and Effectiveness of Two Surgical Interventions in Treatment of Grade I and II Lumber Spondylolisthesis

Background: There are different techniques and technologies available for fusion, and each operative technique has its inherent benefits and disadvantages. Objective: To assess safety and effectiveness of two surgical interventions in grade I and II lumbar spondylolisthesis. Patients and Methods: A Randomized Controlled Clinical Trial of 42 patients aged 18-60years with grade I and II isthmic or degenerative lumber spondylolisthesis attending the Neurosurgery Department, Zagazig University hospitals were recruited to either posterolateral fusion (PLF) or posterior lumbar interbody fusion (PLIF) techniques. Perioperative and postoperative complications were assessed and dealt with appropriately. Radiological investigation, pain score scale (VAS) and Oswestry disability index (ODI) pre- and post-operative were measured. Results: The main complaint was low back pain in all patients and leg pain in 85.71%; 73.81% had degenerative and 26.19% had isthmic spondylolisthesis. L4-5 listhesis (64.29%) and L5/S1 (33.33%). First degree spondylolisthesis (64.29%) and 2 nd degree (35.71%). The mean duration of surgery was 157.14±23.04minutes in PLF group and 190.74±25.62minutes in PLIF group (p=0.0001). The mean amount of blood loss in PLF group was 615 ± 142milliliter, while 730 ± 105milliliter in PLIF group (p=0.028). The mean length of hospital stay was 5.81±1.47days in PLF group compared with 7.1±2.55days In the PLIF group. In PLIF group, complete reduction occurred in 61.9% compared with 38.1% in PLF one. VAS and ODI had significantly decreased postoperative. Conclusion: better results of fusion rate in PLIF surgery in spite of more blood loss, longer duration of surgery and lengthy hospital stay. Similar results for VAS and ODI in both surgeries.