Dr. Siddharth Katkade is a highly skilled, world wide trained and dedicated Spine Surgeon with over 10+ years of experience in field of specialised Spine Care and Orthopaedics.
- Phone:+91 88507 73095
- Email:bombayspineclinic09@gmail.com
Dr. Siddharth Katkade is a highly skilled, world wide trained and dedicated Spine Surgeon with over 10+ years of experience in field of specialised Spine Care and Orthopaedics.
Purpose In 1994, the technique of transdiscal screws fixation in spondylolisthesis was introduced but did not gained popularity
as it failed to address problems with spinal sagittal imbalance, retroverted pelvis, pseudoarthrosis, implant failure and
neural injury. Majority of problems were due to lack of clear indications; hence, in this study, with modification of traditional
technique and use of O-arm navigation for selected group of patients, we have addressed the above problems and given good
to excellent functional outcomes.
Methods We did prospective study on 15 patients with osteoporotic high-grade spondylolisthesis Meyerding grade 3 & 4
admitted in period 2020–2021. Intraoperative assessment was done in form of blood loss, incision length, operative time and
complications. The preoperative & postoperative assessment was done in the form of clinical and radiological parameters.
Results The average follow-up was of 21.2 months (18–24 months). There was no significant difference between pre- &
postoperative spinopelvic parameters. Intraoperative average blood loss was 100 ml (90–120 ml) with mean surgical time
of 138 min (120–150 min). Incision length was about 5–6-cms-posterior midline with two paraspinal 1-cm incisions for
transdiscal screws. Patients were mobilized on postoperative day-2. There was statistically significant improvement in mean
ODI, COMI and VAS for LBP and radicular pain with no intra- or postoperative complication observed till latest follow-up
with all patients showing solid monoblock fusion on 1-year follow-up CT scan.
Conclusions LIMO delta technique is a newly modified version of conventional transdiscal screw technique. Minimal incision,
decreased blood loss & operative time with in situ 3-column rigid fixation and solid fusion minimizing risk of complications
makes this novel technique safer, simpler & effective in osteoporotic HGS.
Osteoporosis · High-grade spondylolisthesis · In situ fixation · O-arm navigation · Delta fixation
About 19% of all cases present as high-grade spondylolisthesis (HGS). Literature suggests surgical management
for HGS. Variety of surgical options like posterior instrumented fusion, posterolateral fusion, anterior or circumferential
fusion from either two-stage or single-stage posterior approach have been described. In 1994, the technique of
transdiscal screws fixation in spondylolisthesis was introduced but did not gained popularity as it failed to address
problems with spinal sagittal imbalance, retroverted pelvis, risk of pseudoarthrosis, implant failure and risk of neural