Evidence map›Paper›PMID 41455089›Full record

ArticleSpine deformity2026

Less is more: in situ delta fixation achieves functional success in elderly osteoporotic patients with high-grade spondylolisthesis.

Vikas Tandon, Gururaj Sangondimath, Ganesh Kumar, Dhaval Makadiya

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Article in Spine deformity, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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4 authors.

Vikas TandonDepartment of Spine Services, Indian Spinal Injuries Centre, Vasant Kunj, New Delhi, 110070, India.ORCID http://orcid.org/0000-0003-2172-0229
Gururaj SangondimathDepartment of Spine Services, Indian Spinal Injuries Centre, Vasant Kunj, New Delhi, 110070, India.
Ganesh KumarDepartment of Spine Services, Indian Spinal Injuries Centre, Vasant Kunj, New Delhi, 110070, India. sgk.ortho@gmail.com.ORCID http://orcid.org/0009-0001-6870-2979
Dhaval MakadiyaDepartment of Spine Services, Indian Spinal Injuries Centre, Vasant Kunj, New Delhi, 110070, India.

Funding

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6 · The paper itself

Abstract

STUDY

designRetrospective case series.

objectiveTo evaluate clinical and radiological outcomes following in situ transdiscal L5-S1 fixation (delta fixation) in elderly osteoporotic patients with high-grade spondylolisthesis, with emphasis on functional recovery and changes in sagittal spinopelvic alignment.

methods15 patients aged > 60 years (mean age 74.9 ± 14.8 years) with Meyerding Grade III-IV L5-S1 spondylolisthesis and osteoporosis (DEXA T score ≤ - 2.5) underwent posterior-only in situ transdiscal fixation and neural decompression. Pre- and postoperative spinopelvic parameters were assessed using standing radiographs and Surgimap® software. Functional outcomes were evaluated using the Oswestry Disability Index (ODI) and the Visual Analog Scale (VAS) for back and leg pain, with a minimum follow-up of 24 months.

resultsAll patients demonstrated significant functional improvement. ODI improved from 66.8 ± 7.1 to 37.3 ± 5.1 (p < 0.001), VAS for low back pain from 8.3 ± 1.5 to 2.7 ± 0.5 (p < 0.001), and VAS for leg pain from 4.5 ± 1.7 to 1.2 ± 0.6 (p < 0.001). Among sagittal parameters, significant improvements were observed in thoracic kyphosis (p = 0.006), sagittal vertical axis (p = 0.010), and PI-LL mismatch (p = 0.032). Changes in pelvic incidence, pelvic tilt, lumbar lordosis, and sacral slope were not statistically significant.

conclusionsIn situ delta fixation with neural decompression offers substantial clinical benefit in elderly osteoporotic patients with high-grade L5-S1 spondylolisthesis. Functional recovery occurred despite limited changes in local spinopelvic sagittal alignment, highlighting that global compensation and neural decompression may suffice for clinical improvement in this high-risk population. LEVEL OF EVIDENCE: Level IV-Case series.

Indexed as

Lumbar VertebraeOsteoporosisSpinal FusionSpondylolisthesisAgedAged, 80 and overDecompression, SurgicalFemaleHumansMaleMiddle AgedRadiographyRetrospective StudiesSacrumTreatment OutcomeOsteoporosisSpinal fusionSpineSpondylolisthesisTreatment outcome

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.