[Scoliosis, spondylolysis and lumbosacral spondylolisthesis. A study of their association apropos of 82 cases in children and adolescents]

Abstract

The authors have reviewed the charts of 82 patients who presented the association of a scoliosis and a spondylolisthesis. They insist upon the necessity to treat each abnormality for itself. 26 patients have been simply followed in the clinic, they required no treatment because of the modicity of the scoliosis and the spondylolisthesis. 23 patients were treated with orthosis because of the scoliosis progression. In this group the spondylolisthesis was not a major concern and remained stable. 15 patients had to be operated on because their scoliosis was threatening. The existence of a spondylolisthesis must not be a deterrent to the arthrodesis, and the orthotic treatment must not be carried on if inadequate. The risks to observe, below the spine fusion a progression of the slippage are extremely low (no case in our series). Although we tried to obtain a fusion of the lysis with an isthmic arthrodesis in two cases, we do not think that it represents a prerequisite to a spine fusion above the level of the lysis. 13 patients had a lumbosacral fusion for a great slippage spondylolisthesis. In this group the scoliosis had no relationship with the spondylolisthesis in four patients. But, in nine patients the scoliosis appeared to be directly related to the spondylolisthesis. The "Arthrodesis-reduction" of the spondylolisthesis enabled us to correct, at least partially, the scoliosis. At last 3 patients had a great slippage spondylolisthesis, and a threatening scoliosis. For these rare cases we propose the lumbosacral fusion with reduction of the spondylolisthesis and then, a few months later, an arthrodesis of the scoliosis as we have carried out twice successfully.