The Use of Crosslinks with Posterior Pedicular Screw Fixation in Lumbar Spondylolisthesis

Abstract

This study was meant to evaluate addition of crosslinks to posterior pedicular screw fixation as a modality for surgical management of lumbar spondylolisthesis.

This study included 50 patients with lumbar spondylolisthesis divided into two groups according to the surgical approach used in treatment. One group with Posterolateral fixation by transpedicular screws and rods and the other Group had cross-links added to the posterior construct.

Cross-link systems have been used to augment segmental spinal instrumentation since the earliest introduction of these fixation systems. Although transverse cross-links have little impact on sagittal motion of spinal constructs, cross-linkage does affect torsional rigidity.

Lumbar spondylolisthesis is a relatively common heterogeneous group of disorders characterized by translational instability where forward displacement of the cephalad vertebrae is the predominant deformity, although some rotational component may exist.

We found no appreciable benefit from using cross-links in short-segment fixation of lumbar spondylolisthesis, where there’s no or little torsional instability encountered.

In our study, adding crosslinks to posterior lumbar constructs had no significant better clinical outcome in improvement rate than posterior pedicular fixation alone, although postoperative radiological evidence suggests some benefit from adding them.