Analysis and treatment of poor outcomes following in situ arthrodesis in adolescent spondylolisthesis

In situ lumbosacral arthrodesis in the treatment of adolescent spondylolisthesis was evaluated in 39 patients. The clinical outcome an average of 4.7 years later was considered excellent or good in 82% of the cases based on their pain and gait. The quality of the fusion mass correlated with outcome. Those patients with the most severe kyphosis (slip angle) had the greatest chance of a poor result. Four patients required reoperation for pseudarthrosis or symptomatic compression of the cauda equina. Three of these were successfully treated with repeat arthrodesis or decompression with sacroplasty or both.