Smiley face shaped rod technique versus instrumented posterolateral fusion in treatment of isthmic lumbar spondylolisthesis

Abstract Background Spondylolysis and spondylolisthesis are a common problem in the population, especially in young males. There are many surgical methods used to treat isthmic lumbar spondylolisthesis and spondylolysis, either direct or indirect. Research has recorded the high efficiency of posterolateral fusion surgery, as one of the most common methods for treating isthmic lumbar spondylolisthesis and spondylolysis, improving clinical outcomes and achieving solid fusion, but some studies have recorded degenerative changes at the adjacent level. Furthermore, available research has recorded varying results in clinical outcomes and solid fusion for direct repair methods. However, they were able to preserve the adjacent level from degenerative changes. The smiley face rod technique is considered one of the modern methods of direct repair, and initial studies have shown satisfactory results in the treatment of isthmic lumbar spondylolisthesis and spondylolysis. However, it is still unknown how efficient this method is and whether it is like posterolateral fusion surgery. So our study aims to compare the smiley face shaped rod technique and posterolateral fusion surgery in terms of improved lower back and lower extremity pain, functional disability, fusion, occurrence of degenerative changes in the adjacent level, length of surgical incision, and amount of blood loss from the patient during surgery. Results The age range of the patients was between 18 and 50 years, 17 males and 13 females, with a ratio of 1.3:1. The statistical results showed that the smiley face shaped rod technique method had an advantage over the instrumental posterolateral fusion method in the degree of improvement of back ( p = 0.002) and lower limb pain ( p = 0.028), also the amount of blood loss was less ( p < 0.001) and the length of the surgical incision was smaller ( p = 0.019). Although the two methods had the same efficiency in solid fusion and no degenerative changes occurred at the adjacent level during 1 year follow-up. Conclusion The smiley face rod technique is a good option for the treatment of lumbar spondylolysis and Spondylolisthesis grade 1.