Background: Lumbar spondylolisthesis results from instability in the lumbar spine, requiring surgical intervention for symptom relief and functional restoration. The use of transpedicular screw fixation and lumbar cages are prevalent surgical techniques designed to stabilize spinal segments and promote fusion. Aim: This study assesses changes in lumbosacral bone density following transpedicular screw fixation with and without lumbar cages in managing lumbar spondylolisthesis. Patients and Methods: A mixed prospective and retrospective cohort of 50 patients diagnosed with lumbar spondylolisthesis at Al-Azhar University hospitals between January 2018 and May 2019 was studied. They were divided into two groups: one underwent screw fixation alone, and the other receiving both screws and lumbar cages. Bone density measurements were taken using dual-energy X-ray absorptiometry (DEXA) before surgery and at one year post-operatively. Results: From the original 50 patients, 50% (25 patients) received screw fixation alone and 50% (25 patients) received screws plus lumbar cages. Neither group had significant demographic or baseline clinical differences (p > 0.05). Both groups decreased bone density postoperatively, but the lumbar cage group had a significantly smaller reduction in T-score changes from preoperative to postoperative measurements (mean T-score change: -0.48 vs. -0.47 in the screw-only group, p = 0.037). Conclusion: Both groups showed a loss in bone density one-year post-surgery, although lumbar cages had a less impact, suggesting a preventive benefit. These findings underline the necessity for patient-specific surgery.

Lumbar spondylolisthesis, transpedicular screw fixation, lumbar cages, bone density, DEXA scans. DOI Number:10.48047/nq.2021.19.1.NQ21044 NeuroQuantology2021;19(1):329