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Review Question - QID 127

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QID 127 (Type "127" in App Search)
In patients with degenerative spondylolisthesis undergoing posterolateral fusion, use of pedicle screws has been shown to confer which of the following effects?

Have no effect on the rate of pseudoarthosis

6%

203/3253

Decrease the rate of pseudoarthrosis

84%

2727/3253

Increase the level of postoperative pain at one year

1%

39/3253

Increase patient satisfaction with the procedure

8%

255/3253

Decrease the rate of postoperative infection

0%

12/3253

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Pedicle screws have been shown to decrease the pseudoarthrosis rate in patients undergoing lumbar fusion for degenerative spondylolisthesis.

The use of pedicle screws in lumbar fusion have increased dramatically in the last decade. While separate studies have shown that pedicle scews increase the rate of fusion, and successful arthrodesis improves outcomes, to date we do not have a study that directly shows pedicle screws improve outcomes, although it is assumed by most.

Fischgrund et al performed a prospective randomized trial comparing instrumentation and fusion versus fusion alone for degenerative spondylolisthesis and spinal stenosis. The fusion rate was 85% for instrumentation and 45% for fusion alone. Interestingly, instrumentation did not affect satisfaction with surgery.

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