Posterolateral Fusion in Spondylolisthesis: Does Disease Type Influence Surgical Outcomes?

Introduction : Posterolateral fusion surgeries are commonly conducted by surgeons. Numerous studies have compared the PLF technique with other approaches in patients with IS and DS. We aimed to assess and compare the outcomes of the posterolateral fusion technique for treating isthmic and degenerative spondylolisthesis in patients referred to the orthopedic clinic at Imam Khomeini Hospital from 2018–2020. Methods : In this prospective cohort study, 30 patients diagnosed with one of the isthmic or degenerative types of spondylolisthesis were recruited via the census method. The extent of spinal involvement and its grade were evaluated and documented through radiological imaging. Additionally, patients completed three questionnaires, namely, the VAS, SF-36, and ODI, both before and one year following surgery. Results : A total of 30 patients were categorized into isthmic and degenerative spondylolisthesis groups, comprising 12 and 18 patients, respectively. All patients were monitored for a period of one year. Postsurgery, both groups showed statistically significant improvements in the VAS and ODI scores. In the isthmic spondylolisthesis group, six out of the eight SF-36 scales showed notable changes, whereas in the degenerative spondylolisthesis group, all the SF-36 scales demonstrated significant improvements. These findings suggest a positive response to surgery via the posterolateral fusion technique. Conclusion : Overall, the posterolateral fusion method enhances functionality while alleviating pain and disability in patients with isthmic and degenerative spondylolisthesis following surgery. However, its effectiveness did not significantly differ between the two groups. Additionally, a notable correlation exists between the grade of spondylolisthesis, hypertension, and smoking in relation to the posterolateral fusion surgical method.