“The third problem with an ALIF for an isthmic spondylolisthesis is that there already is a defect in the posterior elements. The ALIF does provide some stability with the screw in cage, but without the stability of the posterior elements (due to the pars fractures-see website), this construct is not as stable as with a posterior approach”
Thank you always ! Your comment above is where my apprehension lies with just having a stand alone ALIF.
1.) When you say the construct is not as stable as with the stability of the posterior elements, what does this mean exactly ? Is it fair to say the the TLIF with the posterolateral fusion provides that much more stability with isthmic spondylolisthesis ?
2.) Also, if I am not having any leg pain, do you still believe it is absolutely necessary to remove pars defect!
You are correct, my intention is to have one surgery, not having to go back for more.