Background: Spondylolisthesis describes a condition of a forward slippage of one vertebra
over another, which may or may not be associated with demonstrable instability. Spinal fixation
is a neurosurgical procedure in which two or more vertebrae are anchored to each other through
a synthetic "vertebral fixation device"
Objective: To determine the demographic distribution of different patient factors and the most
commonly vertebra undergo fixation in the thoracolumbar instrumentation.
Patients and Methods: one hundred patients were evaluated during the period of this study in
a retrospective manner from January 2013 to January 2015 in four hospitals in Baghdad
(Neurosurgical Teaching Hospital, Neuroscience hospital, Al-Kahdymia Teaching Hospital,
Medical City\Ghazy AL-Hariri Hospital). The patients' data regarding the etiology of
instability, mechanism of injury for trauma patients, gender, age, segments undergoing
instrumentation were identified.
Results: The study revealed female predominance over male: female ratio of 1:2.7, the age
distribution was highest from 3rd to 7th decades of life, the etiology of instability was either
degenerative or traumatic, the degenerative instability was 65% while traumatic cases was
35%. The neurological status of the patients was assessed by neurological examination and
revealed 75% with incomplete deficit and 25% with complete neurological deficit, the most
common pathologically involved vertebra was the L4, the most common vertebrae used in
fixation were the L4 and L5 levels, the most common type of fixation used was the short
segment fixation.
Conclusion: Posterior spinal fixation with pedicle screws and rods system is an effective and
safe method in maintaining the stability of spine. The intraoperative imaging is important in
maintaining safe trajectory of screws. Short segment fixation using the posterior approach with
pedicle screw-rod fixation devices achieve good stabilization. The ideal candidates for
undergoing posterior spinal fixation are patients with unstable fractures & incomplete
neurological deficit.
Recommendation: The use of intraoperative neuro-monitoring, use of navigation system, use
of fluoroscopy and the O-arm in spinal fixation surgery. Bone fusion is recommended for each
patient.
Keywords: Thoracolumbar spine, spondylolisthesis, pedicle screw fixation
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Vol. 3, Issue 2, (2016),
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