Dados do Trabalho

Título

L5 Radiculopathy After Formal Reduction of High-Grade SDSG Type 5 and 6 L5-S1 Isthmic Spondylolisthesis with 2-Year Follow-Up.

Objetivo

Surgery is the main treatment for patients with high-grade L5-S1 isthmic spondylolisthesis, which
can result in neurologic complications, but little is known about its clinical course. The present study evaluated the
presence of L5 radiculopathy in high-grade L5-S1 spondylolisthesis in adults in pre- and postoperative periods and after
a 2-year follow-up.

Metodologia

A series of 16 patients who underwent reduction and instrumented fusion for high-grade 5 and 6
spondylolisthesis between 2018 and 2019 were retrospectively evaluated in the pre- and postoperative periods as well as
after 6 weeks, 3 months, 6 months, and 1 and 2 years of follow-up. Clinical and surgical data on possible neurological
complications of L5 radiculopathy were prospectively collected.

Resultados

The age was 20.1 6 12.0 years, and preoperative L5-S1 slip was 89.0%. Five patients presented motor
deficit in the preoperative period. In the immediate postoperative period, 9 patients (56%) experienced motor deficits or
worsening of the preoperative condition. At the 6-week follow-up, only 1 patient showed resolution of the motor deficit.
Three patients presented healed motor deficits after 3 months, and 1 patient demonstrated a healed L5 motor
radiculopathy after 6 months. At the 1-year follow-up, only 1 patient exhibited an L5 radiculopathy motor deficit, and
at the 2-year follow-up, none of the patients exhibited an L5 radiculopathy motor deficit.

Conclusões

L5 radiculopathy was frequent in the preoperative period and increased after reduction and
instrumented fusion of high-grade L5-S1 spondylolisthesis in the postoperative period and in the 6-week follow-up.
Three and 6 months after the surgery, there were consecutive motor improvements. After 2 years of follow-up, no
patients showed neurological deficit of L5 radiculopathy.

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