• Christos Karampalis, Michael Grevitt, Masood Shafafy, and John Webb.
• Centre for Spinal Studies and Surgery, Nottingham University Hospitals NHS Trust, Queens Medical Centre Campus, Derby Road, Nottingham, NG7 2UH, UK. cvkortho@gmail.com
• Eur Spine J. 2012 May 1;21 Suppl 2:S200-6.

PurposeTo report the results of a cohort of patients treated with this technique high lighting radiological and functional outcomes, discussing also benefits arising from a gradual reduction procedure compared with other techniques.MethodsWe evaluated nine patients who have undergone high-grade listhesis reduction and circumferential fusion at our institution from 1988 to 2006. Average length of follow-up was 11 years (5-19). Functional outcomes and radiological measurements were recorded and reported.ResultsSlip magnitude was reduced by an average of 2.9 grades (Meyerding classification). Slip angle improved by an average of 66% (p = 0.0001), lumbosacral angle by 47% (p = 0.0002), sacral rotation by 51% (p = 0.0068) and sacral inclination by 47% (p = 0.0055). At the latest follow-up 88.9% had achieved solid fusion. Post-operative 10-point Visual Analogue Score (VAS) for back pain had improved by 70% (p < 0.001) and that for leg pain by 76% (p < 0.001) compared with pre-operative score. Average postoperative Oswestry Disability Index for all patients was 8% (range 0-16%) and that for Low Back Outcome Scores was 56.6 (range 44-70). All components of Short Form 36 Health Survey were greater than 80%. Overall patients' expectations were met in 100%.ConclusionsThis is an effective and safe technique which addresses the lumbosacral kyphosis and cosmetic deformity without the neurological complications which accompany other reduction and fusion techniques for high-grade spondylolisthesis.

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