Posterior Lumbar Element Enforcement by Decompression Alone with Interspinous Fixation without Interbody Fusion for the Surgical Management of Lumbar Spondylolisthesis

In degenerative lumbar spondylolisthesis, interbody fusion surgery (IFS) has long been recommended as the gold standard of surgical management. However, IFS is less recommended for high-risk patients such as the elderly because it involves extensive surgery, with a long operation time and high volumes of blood loss, which lead to marked perioperative morbidity. We report an alternative primary and salvage treatment technique for high-risk lumbar spondylolisthesis through posterior lumbar element reinforcement using interspinous fixation (ISF) and decompression alone without interbody fusion. Plain radiographs, computed tomography scans, and magnetic resonance imaging, taken at different intervals, were used to measure local disc height (DH), vertebral body slippage (BS), and segmental motion angle (SMA). A visual analogue scale (VAS) and the Oswestry disability index (ODI) were applied pre-operation and at the last follow-up. The local SMA decreased significantly by 3.46±3.07°, from 10.61±3.42° preoperatively to 7.15±3.70 at the last follow-up (p