| Spondylolytic spondylolisthesis is an anterior slip of one verebral body onto another caused by a disconnection of the pars interarticularis of the arch. Patients present with radicular pain or neurogenic claudication with or without backpain caused by nerve root compression underneath the newly formed pseudojoint, or compression in the foramen between pedicle and slipped disc. Surgical treatment consists of excision of the pseudojoint (nerveroot decompression according to Gill) mostly in combination with instrumented fusion. Instrumented spondylodesis is major surgery with a substantial complication rate and it's necessity has not been proven. Nerve root decompression according to Gill is a less invasive procedure with short hospitalisation, quick mobilisation and fast resumption of daily activities. Therefore, we postulate that Gill's procedure is more cost-effective on the short term (12 weeks) and at least equal cost-effective on the long term (2 years). Up to now, no randomised trial has been conducted comparing instrumented fusion with nerve root decompression in the treatment of radicular pain caused by spondylolytic spondylolisthesis. The Sciatica-Gill trial is a randomised cost-effective study about nerve root decompression according to Gill versus instrumented fusion in the treatment of patients with radicular legpain or neurogenic claudication due to spondylolytic spondylolisthesis. |
