Objective: To discuss the surgical treatment of multilevel lumbar degenerative spondylolisthesis.
Methods: From March 2005 to September 2008, 25 cases of multilevel lumbar degenerative spondylolisthesis were treated with total laminectomy, reduction of spondylolisthesis and 360 degrees circumferential fusion through interbody (PLIF), transverse process (PLF) and pedicle screw fixation. All cases were followed up for 0.5 - 4 years. The Lenke grading system was used to assess the spinal fusion and Henderson grading system was used to assess the clinical outcomes.
Results: Complete reduction of spondylolisthesis was achieved in all cases. The bone fusion was grade A in 23 cases, grade B in 2 cases. The clinical outcome was excellent in 16 cases, good in 6 cases and poor in 3 cases.
Conclusions: The pathogenesis of lumbar degenerative multilevel spondylolisthesis is different from that of single-level spondylolisthesis. Complete decompression, reduction of spondylolisthesis sufficient fusion and reliable pedicle screw fixation can provide successful interbody fusion and satisfactory clinical results.It's crucial to reduce multilevel spondylolisthesis by proper techniques based on different types of listhesis.