Double-level isthmic spondylolisthesis treated with posterior lumbar interbody fusion: A review of 32 cases

- The incidence of double-level isthmic spondylolisthesis is rare.
- Thirty-two patients with double-level isthmic spondylolisthesis underwent PLIF with autogenous bone chips were reviewed.
- This is the largest series of double-level spondylolisthesis treated by this technique.
- PLIF with autogenous bone chips seems to be a viable approach in the treatment of double-level isthmic spondylolisthesis.

ObjectiveThe incidence of double-level isthmic spondylolisthesis is rare. The aim of this study is to evaluate the short-term functional and radiological outcomes of surgical treatment for double-level isthmic spondylolisthesis.Patients and methodsBetween 2004 and 2014, thirty-two patients with double-level isthmic spondylolisthesis who underwent posterior lumbar interbody fusion (PLIF) with autogenous bone chips were reviewed retrospectively. The clinical outcomes were measured by VAS (Visual analog scale) and JOA(Japanese Orthopedic Association) score.ResultsAt an average follow-up of 2.8 years, the mean score on the VAS of back pain and sciatica decreased from 6.48 and 4.26 points preoperatively to 1.82 and 1.10 points at final follow-up, respectively. The average JOA score improved from 13.8 ± 3.1 preoperative to 25.6 ± 1.3 (range, 17-28) points postoperative. The average recovery rate was 77.6%. The good and excellent rate was 84.3% (27/32). The fusion rate was 87.5% (28/32). Changes in disc height, degree of listhesis, whole lumbar lordosis, and sacral inclination between the pre- and postoperative periods were significant.ConclusionsOur findings suggest that PLIF with autogenous bone chips for double-level isthmic spondylolisthesis could yield good functional short-term results. It seems to be a viable approach in the treatment of double-level isthmic spondylolisthesis.