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January 19, 1957, Vol 163, No. 3 >
ARTICLE | January 19, 1957

REVIEW OF SEVENTY-THREE CASES OF SPONDYLOLISTHESIS TREATED BY ARTHRODESIS FREE

George Hammond, M.D.; Robert E. Wise, M.D.; G. Edmund Haggart, M.D.
[+] Author Affiliations

Read before the Section on Orthopedic Surgery at the 105th Annual Meeting of the American Medical Association, Chicago, June 13, 1956.


Boston


JAMA. 1957;163(3):175-180. doi:10.1001/jama.1957.02970380017006
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References

• The finding of spondylolisthesis was accompanied by the complaint of backache with or without lower extremity pain in 72 of 73 patients; in the remaining case the symptom was that of unilateral sciatica. In 35 cases no history of trauma could be elicited. In five cases the fifth lumbar vertebra had slipped forward more than half the distance across the superior surface of the sacrum.

The basic treatment in all 73 cases was an arthrodesis; in addition, protruding disks required excision in three cases. Sixty patients were restudied 3 to 19 years after the operation. The desired solid ankylosis had been achieved in only 24 patients. The pseudarthroses found in the other 36 were more frequent in the patients receiving bone grafts from a bone bank instead of iliac grafts, or confined to bed for only four weeks or less. Significant pain persisting in the legs after operation was explained by the finding of pseudarthrosis in 6 out of the 10 patients whose results were classified as fair or poor, but moderate pain continued also in 3 patients in whom solid fusion was achieved.

It is recommended that further efforts be made to improve the technique of arthrodesis in this situation, that use of a bilateral spica cast to the knees be continued for three months after operation, and that early ambulation be avoided. The success of the operation should be verified by suitable roentgenograms, and a program of exercise and training should begin as soon as the patient becomes ambulatory.

REFERENCES

1 +
Harris, R. I.:  Spondylolisthesis: Hunterian lecture , Ann. Roy. Coll. Surgeons England 8:259-297 ( (April) ) 1951;.
2 +
Meyerding, H. W.:  Spondylolisthesis: Surgical Treatment and Results , J. Bone & Joint Surg. 25: 65-77 ( (Jan.) ) 1943;.
3 +
Adkins, E. W. O.:  Spondylolisthesis , J. Bone & Joint Surg. 37-B: 48-62 ( (Feb.) ) 1955;
4 +
Briggs, H., and Keats, S.:  Laminectomy and Foraminotomy with Chip Fusion: Operative Treatment for Relief of Low-Back Pain and Sciatic Pain Associated with Spondylolisthesis , J. Bone & Joint Surg. 29: 328-334 ( (April) ) 1947;.
5 +
Caldwell, G.:  Spondylolisthesis: Analysis of 59 Consecutive Cases , Ann. Surg. 119:485-497 ( (April) ) 1944;.
6 +
Gill, G. G.; Manning, J. G., and White, H. L.:  Surgical Treatment of Spondylolisthesis Without Spine Fusion: Excision of Loose Lamina with Decompression of Nerve Roots , J. Bone & Joint Surg. 37-A: 493-520 ( (June) ) 1955;.
7 +
James, A., and Nisbet, N. W.:  Posterior Intervertebral Fusion of Lumbar Spine: Preliminary Report of New Operation , J. Bone & Joint Surg. 35-B: 181-187 ( (May) ) 1953;.
8 +
Meyerding, H. W.:  Low Backache and Sciatic Pain Associated with Spondylolisthesis and Protruded Intervertebral Disc: Incidence, Significance, and Treatment , J. Bone & Joint Surg. 23: 461-470 ( (April) ) 1941;.
9 +
Bosworth, D. M.; Fielding, J. W.; Demarest, L., and Bonaquist, M.:  Spondylolisthesis: Critical Review of Consecutive Series of Cases Treated by Arthrodesis , J. Bone & Joint Surg. 37-A: 767-786 ( (July) ) 1955;.
10 +
Barr, J. S.:  Spondylolisthesis , editorial, J. Bone & Joint Surg. 37-A: 878-880 ( (July) ) 1955;.
11 +
Meyerding, H. W.:  Spondylolisthesis as Etiologic Factor in Backache , J. A. M. A. 111: 1971-1976 ( (Nov. 26) ) 1938;.
12 +
Friberg, S.:  Studies on Spondylolisthesis , Acta chir. scandinav. ( (supp. 55) ) 82: 1-40, 1939;.
13 +
Cleveland, M.; Bosworth, D. M., and Thompson, F. R.:  Pseudarthrosis in Lumbosacral Spine , J. Bone & Joint Surg. 30-A: 302-312 ( (April) ) 1948;.
14 +
Bosworth, D. M.:  Technique of Spinal Fusion in Lumbosacral Region by Double Clothespin Graft and Results , in American Academy of Orthopedic Surgeons: Instructional Course Lectures , vol. 9, edited by C. N. Pease, Ann Arbor, Mich., J. W. Edwards, 1952;, pp. 44-52.
15 +
Barr, J. S., in dicussion on Cleveland and others.7

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1 +
Harris, R. I.:  Spondylolisthesis: Hunterian lecture , Ann. Roy. Coll. Surgeons England 8:259-297 ( (April) ) 1951;.
2 +
Meyerding, H. W.:  Spondylolisthesis: Surgical Treatment and Results , J. Bone & Joint Surg. 25: 65-77 ( (Jan.) ) 1943;.
3 +
Adkins, E. W. O.:  Spondylolisthesis , J. Bone & Joint Surg. 37-B: 48-62 ( (Feb.) ) 1955;
4 +
Briggs, H., and Keats, S.:  Laminectomy and Foraminotomy with Chip Fusion: Operative Treatment for Relief of Low-Back Pain and Sciatic Pain Associated with Spondylolisthesis , J. Bone & Joint Surg. 29: 328-334 ( (April) ) 1947;.
5 +
Caldwell, G.:  Spondylolisthesis: Analysis of 59 Consecutive Cases , Ann. Surg. 119:485-497 ( (April) ) 1944;.
6 +
Gill, G. G.; Manning, J. G., and White, H. L.:  Surgical Treatment of Spondylolisthesis Without Spine Fusion: Excision of Loose Lamina with Decompression of Nerve Roots , J. Bone & Joint Surg. 37-A: 493-520 ( (June) ) 1955;.
7 +
James, A., and Nisbet, N. W.:  Posterior Intervertebral Fusion of Lumbar Spine: Preliminary Report of New Operation , J. Bone & Joint Surg. 35-B: 181-187 ( (May) ) 1953;.
8 +
Meyerding, H. W.:  Low Backache and Sciatic Pain Associated with Spondylolisthesis and Protruded Intervertebral Disc: Incidence, Significance, and Treatment , J. Bone & Joint Surg. 23: 461-470 ( (April) ) 1941;.
9 +
Bosworth, D. M.; Fielding, J. W.; Demarest, L., and Bonaquist, M.:  Spondylolisthesis: Critical Review of Consecutive Series of Cases Treated by Arthrodesis , J. Bone & Joint Surg. 37-A: 767-786 ( (July) ) 1955;.
10 +
Barr, J. S.:  Spondylolisthesis , editorial, J. Bone & Joint Surg. 37-A: 878-880 ( (July) ) 1955;.
11 +
Meyerding, H. W.:  Spondylolisthesis as Etiologic Factor in Backache , J. A. M. A. 111: 1971-1976 ( (Nov. 26) ) 1938;.
12 +
Friberg, S.:  Studies on Spondylolisthesis , Acta chir. scandinav. ( (supp. 55) ) 82: 1-40, 1939;.
13 +
Cleveland, M.; Bosworth, D. M., and Thompson, F. R.:  Pseudarthrosis in Lumbosacral Spine , J. Bone & Joint Surg. 30-A: 302-312 ( (April) ) 1948;.
14 +
Bosworth, D. M.:  Technique of Spinal Fusion in Lumbosacral Region by Double Clothespin Graft and Results , in American Academy of Orthopedic Surgeons: Instructional Course Lectures , vol. 9, edited by C. N. Pease, Ann Arbor, Mich., J. W. Edwards, 1952;, pp. 44-52.
15 +
Barr, J. S., in dicussion on Cleveland and others.7

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