Comparison of Clinical Outcomes of Conservative Treatment, Percutaneous Intralaminar Stabilization of Pars Defect, and Posterolateral Fusion with Interbody Fusion in Spondylolysis

Abstract

Aim: This study aimed to compare the clinical efficacy of posterior lumbar interbody fusion (PLIF), percutaneous intralaminar screw pars stabilization (PS), and conservative treatment (CT) for symptomatic spondylolysis (SL). Material and Method: A retrospective randomized study was conducted on 45 patients, with 15 in each group (PLIF, PS, and CT), who underwent bilateral L5 SL and were treated between 2017 and 2022. Surgical indications included low back pain lasting >6 months that was unresponsive to CT and without sciatica. The CT group comprised patients with similar pain profiles. Clinical outcomes were measured using the visual analog scale (VAS), Oswestry Disability Index (ODI), and Short Form 36 (SF-36) scores at 0, 1, 3, 6, and 12 months. Results: The study included 65% female patients with a mean age of 52 (PLIF), 44 (PS), and 46 (CT) years. Both the PS and PLIF groups showed significant clinical improvement compared with the CT group (p<0.05). No intraoperative complications were observed. The mean hospital stay was shorter in the PS group (2.7±1.3 days) than in the PLIF group (5.4±1.8 days). The operation time was 40±15 minutes for PS and 168±41 minutes for PLIF, with blood loss of 50±15 cc for PS and 350±170 cc for PLIF. Conclusion: PS and PLIF resulted in better clinical outcomes than CT for L5 spondylolysis. PS is a minimally invasive and safe option with less muscle and soft tissue disruption; however, the final follow-up scores did not differ significantly between the PS and PLIF groups.

Keywords

• Spondylolysis
• pars stabilization
• isthmic defect
• intralaminar screw
• conservative treatment

Kaynakça

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