Reduction of severe lumbosacral spondylolisthesis. A report of 22 cases

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with a ten-year follow-up period. O'Brien JP. Mehdian H. Jaffray D. Department for Spinal Disorders, Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry, Shropshire, United Kingdom. Clin Orthop. (300):64-9, 1994 Mar. Severe spondylolisthesis produces a kyphos at the lumbosacral junction. Reduction can be complicated by injury to the cauda equina. To prevent this, a posterior decompression and fusion is carried out before a slow reduction in extension. An anterior fusion with internal fixation then locks the reduction. Using these principles, a good reduction was achieved in 20 of 22 patients. Only two patients suffered a permanent neurologic deficit consisting of slight loss of ankle dorsiflexion. Severe spondylolisthesis can be safely reduced by this method.