Outcome of posterior lumbar interbody fusion in low-grade spondylolisthesis

Vamshikrishna Chand Nimmagadda, Hiranya Kumar Seenappa, Karthik Narayanamurthy Mittemari, Rajashree Paidipati


Background: Spondylolisthesis is the slippage of all or part of one vertebra in relationship to a caudal vertebra, most commonly occurring in the lumbar spine. Fusion is the recommended treatment of choice. Posterior stabilization with posterior lumbar interbody fusion (PLIF) is an established procedure with good outcomes. To study functional and radiological outcomes of PLIF in grade 1 and 2 lumbar spondylolisthesis.

Methods: This is a prospective study in 30 patients who underwent PLIF and followed up for one year. Functional outcomes were measured in terms of visual analogue scale (VAS) and the Modified Oswestry Disability Index (ODI), and the fusion was assessed on plain radiographs.

 Results: There was a significant improvement in VAS of low back pain (90.71%, p<0.001) and VAS of radiating (82.52%; p<0.001). The ODI scores were significantly improved (63.65%, p<0.001) at 1 year follow up. The fusion rate was 70%, and 56.66% patients reported excellent outcomes.

Conclusions: Based on functional outcomes and the fusion rates of PLIF, we conclude that PLIF is a recommended and excellent surgical option in the management of low grade lumbar spondylolisthesis.


Spondylolisthesis, Posterior lumbar interbody fusion, Fusion, Modified Oswestry Disability index

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Guigui P, Ferrero E. Surgical treatment of degenerative spondylolisthesis. Orthop Traumatol Surg Res. 2017;103(1S):S11-20.

Lan T, Hu SY, Zhang YT, Zheng YC, Zhang R et al. Comparison Between Posterior Lumbar Interbody Fusion and Transforaminal Lumbar Interbody Fusion for the Treatment of Lumbar Degenerative Diseases: A Systematic Review and Meta-Analysis. World Neurosurg. 2018;112:86-93.

Nimmagadda V, Seenappa HK, Mittemari K. Outcomes of instrumented posterolateral fusion in patients with low grade lumbar spondylolisthesis. International Journal of Orthopaedics Sciences. 2020;6:139-42.

Shinya O, Takenori O, Akira M, Takamitsu H, Tomio Y, Motoki I. Surgical Outcomes of Posterior Lumbar Interbody Fusion in Elderly Patients, The Journal of Bone & Joint Surgery. 2006;88(12):2714-20.

Williams KD. Spondylolisthesis. In: Frederick M Azar, James H Beaty, Terry Canale S. editors. Campbell’s Operative Orthopaedics. 14th ed. Elsevier. 2021;1825-6.

Aygün H, Cakar A, Hüseyinoğlu N, Hüseyinoğlu U, Celik R. Clinical and radiological comparison of posterolateral fusion and posterior interbody fusion 95 techniques for multilevel lumbar spinal stabilization in manual workers. Asian Spine J. 2014;8(5):571-80.

Liu X, Wang Y, Qiu G, Weng X, Yu B. A systematic review with meta-analysis of posterior interbody fusion versus posterolateral fusion in lumbar spondylolisthesis. Eur Spine J. 2014;23:43-56.

Wang YXJ, Káplár Z, Deng M, Leung JCS. Lumbar degenerative spondylolisthesis epidemiology: A systematic review with a focus on gender-specific and age-specific prevalence. J Orthop Translat. 2016;11:39-52.

Collis JS. Total disc replacement: a modified posterior lumbar interbody fusion. Report of 750 cases. Clin Orthop Relat Res. 1985;193:64-7.

Wiltse LL, Winter RB. Terminology and measurement of spondylolisthesis. J Bone Joint Surg. Am. 1983;65:768- 72.

Meisel HJ, Schnöring M, Hohaus C, Minkus Y, Beier A, Ganey T, Mansmann U. Posterior lumbar interbody fusion using rhBMP-2. Eur Spine J. 2008;17(12):1735-44.

Endler P, Ekman P, Möller H, Gerdhem P. Outcomes of Posterolateral Fusion with and without Instrumentation and of Interbody Fusion for Isthmic Spondylolisthesis: A Prospective Study. J Bone Joint Surg. Am. 2017;99(9):743-52.