Analysis of results on minimum 4-year follow-up of modified posterior lumbar interbody fusion for the treatment of isthmic spondylolisthesis / 中国骨伤

ABSTRACT

<p><b>OBJECTIVE</b>To investigate the long-term results of modified Jaslow technique to treat isthmic spondylolisthesis.</p><p><b>METHODS</b>From April 2000 to January 2002, 75 patients with isthmic spondylolisthesis (Meyerding grade I had 24 cases, grade II had 35, grade III had 16)were treated with a modified Jaslow technique using one single fusion cage on the symptomatic side. There were 35 males and 40 females with an average age of 40 years old, ranging from 23 to 71 years. Clinical symptoms included intermittent claudication, radicular pain and low back pain. Pre- and postoperative percentage slip, lumbar lordosis, height ratio of intervertebral space and the fusion ratio were analyzed according to radiographic conditions; Visual Analogue Pain Score (VAS), Oswestry Disability Index (ODI), Houshuxun criterion were applied to assess the pain and the conventional functions.</p><p><b>RESULTS</b>All patients were followed up from 48 to 62 months with an average of 50.2 months. The percentage slip reduced from 35.6% preoperative to 9.7% at the last follow-up (corrected 72.8%), lumbar lordosis from (53.6 +/- 15.7) degrees to (51.2 +/- 17.1) degrees and the height ratio increased from (58.6 +/- 12.3)% to (91.5 +/- 11.2)%, the rate of fusion was 97.3% (73/75) at the last follow-up. The mean VAS and ODI before operation was (6.2 +/- 2.5) scores and (47.8 +/- 10.3)%, respectively, decreased to (2.5 +/- 1.9) scores and (10.3 +/- 3.0)% at the last follow-up. There was statistical significance in all items except for lumbar lordosis. According to Houshuxun criterion, the results was excellent in 53 cases, good in 12, fair in 8 and poor in 2, the rate of excellent and good was 86.7%. Complication included 2 case internal fixation failure, 3 cases transient neurologic deficits and 3 cases pseudoarticulation formation.</p><p><b>CONCLUSION</b>The modified Jaslow technique is suitable for isthmic spondylolisthesis (Meyerding I - III), which has advantage of sufficient decompression, solid fixation and can obtain satisfactory clinical results with long-term follow-up.</p>