Paper #III-3

DELTA FIXATION: INITIAL CLINIC RESULTS WITH A NOVEL METHOD FOR LUMBOSACRAL FIXATION

Daniel Latt, MD PhD

Montreal, QC

Co-Authors

Abdul Alobaid, MD

Jean Ouellet, MD

Rudy Reindl, MD

Max Aebi, MD

Vincent Arlet, MD

This study reports the initial clinical experience with delta fixation- a novel method of fixation used during fusion for the treatment of severe L5/S1 spondylolisthesis. The surgical technique consists of placing two screws from the posterolateral sacrum into the L5 vertebral body. It provides rigid initial fixation for posterolateral and posterior lumbar interbody fusion (PLIF).

10 patients with grade II-IV L5/S1 spondylolisthesis who failed conservative treatment underwent L5/S1 fusion with delta fixation. The average follow-up was 17 months. The outcomes measured were difference in Oswestry disability indices before surgery and at follow-up, back and leg pain using on visual analog scale, and evidence of fusion on flexion/extension radiographs.

The mean decrease in Oswestry score was 70% (from 37 to 8) with a 62% decrease in back pain and a 57% decrease in leg pain. Radiographic fusion was achieved in 80% of patients.

Delta fixation is a novel method of fixing L5 to S1in the setting of high grade spondylolisthesis. Our initial clinical experience has shown this method to be far superior to instrumented posterolateral fusion alone (40% decrease in oswestry, 60% fusion rate). This method will likely become the new standard in fixation during fusion for high grade L5/S1 spondylolisthesis.