Sagittal Parameters After Mono Segmental Lumber Fusion: Interbody Versus Postrolateral Fusion

Study Overview
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Brief Summary
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To compare postoperative radiographic sagittal parameters after monosegmental lumbar fusion: posterior lumbar interbody fusion versus postrolateral fusion in treatment of lumbar spine instability

Detailed Description
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The term spondylolisthesis refers to slipping of a vertebra relative to an adjacent vertebra,and there are two mean types degenerative and lytic : Degenerative spondylolisthesis is secondary to osteoarthritis leading to facet incompetence and disc degeneration.This condition allows anterior translation of one vertebra on another. Spondylolysis is the break in the pars interarticularis and is the precursor of lytic spondylolisthesis which associated with a pars fracture When nonoperative care fails and surgery is being considered, the type of fusion should be tailored to the specific pathology being treated.So there are different operations to correct this instability like postrolateral fusion (PLF) and posterior lumber interbody fusion (PLIF) PLF decreases segmental motion in the posterior column, which presumably reduces facet joint pain.Theoretical advantages of PLIF include decompression of exiting nerve roots by distraction of the collapsed disc space, achievement of optimal fusion in relation to the load-bearing capacity of the vertebral bodies and possibly attainment of a better fusion rate

Official Title
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Sagittal Parameters After Mono Segmental Lumber Fusion: Interbody Versus Postrolateral Fusion

Conditions
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Lumbar Spine Fusion

Intervention / Treatment
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* Procedure: posterolateral fusion
* Procedure: posterior lumbar interbody fusion


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Adult patient older of 18 years old. Patients with lytic spondylolisthesis Low grade spondylolisthsis 1,2 Exclusion Criteria: Traumatic spondylolysis Previous spine surgery. Patient younger 18 years old High grade spondylolisthsis 3,4,5 - multiple levels spondylolithises

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: PLF<br>posterolateral fusion | Procedure: posterolateral fusion<br>* Instrumented posterolateral fusion is a spinal surgery that combines bone graft fusion with the use of hardware like screws and rods to stabilize the spine, correct alignment, and promote successful fusion. It's used for various spinal conditions.<br>* Other names: PLF;|
| Active Comparator: PLIF<br>posterior lumbar interbody fusion | Procedure: posterior lumbar interbody fusion<br>* Posterior lumbar interbody fusion (PLIF) is a spinal surgery that involves removing problematic discs, inserting bone graft material, and sometimes a spacer, to promote fusion and stabilize the spine.<br>* Other names: PLIF;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Spino sacral angle | Which is the angle fromed between the line from front side of t1 to the middle of sacrum and the line passing through the sacral plateau | 6month post op | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| T1 pelvic angle | The angle between the line from centroid of t1 to the femoral head axis and the line from femoral head axis to middle of the s1 end plate | Pre op. Post op immediately. 6month post op | 
| Pelvic incidence | Is the angle between the line perpendicular to the s1 end plate from the midpoint of the end plate and the connecting line from the midpoint of the s1 end plate to center of the femoral head | Pre op. Post op immediately. 6month post op | 
| Pelvic tilt | Is the angle between the connecting line from the midpoint of the s1 end plate to the center of the femoral head and the vertical line | Pre op. Post op immediately. 6month post op | 
| Sacral slope | Is the angle between the tangent and the horizontal line of s1 end plate | Pre op. Post op immediately. 6month post op | 
| Lumbar lordosis | Is the junction of the thoracic kyphosis to the s1 end plate | Pre op. Post op immediately. 6month post op |