Abdulamjeed AlzakriKing Saud University , Saudi Arabia
Title: Restoration of normal pelvic balance from surgical reduction In high-grade spondylolisthesis
Purpose: To investigate the effectiveness of surgical reduction in high-grade spondylolisthesis in maintaining or restoring a normal pelvic balance, as related to the QoL.
Methods: It is a retrospective analysis of prospectively collected data of 60 patients (17 males, 43 females) aged 15 ± 3.1 years who underwent surgery for high-grade spondylolisthesis and were followed for a minimum of 2 years after surgery. Patients with a residual high-grade slip following surgery were referred to the postoperative high-grade (PHG) group, while patients with a residual low-grade slip were referred to the postoperative low-grade (PLG) group. Pelvic balance was assessed from pelvic tilt and sacral slope, in order to identify patients with a balanced pelvis or unbalanced pelvis. The SRS-22 questionnaire was completed before surgery and at last follow-up.
Results: Postoperatively, there were 36 patients with a balanced pelvis and 24 patients with an unbalanced pelvis. The improvement in QoL was better in patients with a postoperative balanced pelvis. There were 14 patients in the PHG group and 46 patients in the PLG group. Four of seven patients (57%) in the PHG group and 21 of 26 patients (81%) in the PLG group with a preoperative balanced pelvis maintained a balanced pelvis postoperatively (P = 0.1). None of the patients in the PHG group and 11 of 20 patients (55%) in the PLG group improved from an unbalanced to a balanced pelvis postoperatively (P < 0.05).
Conclusions: Surgical reduction in high- to low-grade slip is more effective in maintaining and restoring a normal pelvic balance postoperatively.
Abdulmajeed Alzakri has completed his residency in orthopedics surgery at the University of Strasbourg, France. He did double fellowship in pediatric and adult spinal surgery at the Montreal University, Canada then at the Bordeaux University, France. He had a master degree in clinical biomechanics from ENSAM center, France.