Four patients who had had grade-III or grade-IV symptomatic
spondylolisthesis and a failed posterior or posterolateral arthrodesis were
treated with transperitoneal anterior lumbosacral interbody arthrodesis and
fixation with a fibular graft; the procedure was sometimes followed by
posterolateral arthrodesis of the spine. The patients were examined ten to
twenty-two years after the salvage operation. At follow-up, all had a solid
fusion of the fifth lumbar to the first sacral vertebra. No neurological
deficits had worsened and no iatrogenic neurological deficits had
developed. The slip angle had improved by an average of 23.2 degrees
(range, 12 to 35 degrees).