Long-term results of pedicle screw plus cage fixation for lumbar spondylolithesis / 中国矫形外科杂志

ABSTRACT

[Objective]To investigate the late results of pedicle screw system and cage fixation for lumbar broken isthmus spondylolisthesis.[Method]Totally 86 patients with broken isthmus spondylolisthesis were collected and analyzed from October 1996 to October 2002,they were all reduced and fixed with pedicle screw system and cage.Group 1,62 patients were put one cage in the interbody at an angle of 45 degree from posterior to anterior,while Group 2,24 patients were put two cages in the interbody vertically from posterior to anterior.The height of interbody and the most proximal interbody' s height were measured,the rate was calculated.These rate were acquired preoperatively,2 weeks postoperatively and follow-up period respectively.[Result]The follow-up period was 24~96 months,averaged 35 months.The excellent and good rates were 80.23 per cent,according to Nakai standard.Ninteen patients with one degree spondylolisthesis were reduced anatomically after surgery.Fifty-one patients with two degree spondylolisthesis were reduced anatomically except 5 patients with one degree spondylolisthesis left.Sixteen patients with three degree spondylolisthesis were reduced anatomically except 4 patients with one degree spondylolisthesis left.There were loss of spondylolisthesis reduction at follow-up period comparing with 2 weeks postoperatively in two groups.However there was no statistical significance between the two groups.[Conclusion]Lumbar spondylolisthesis should be treated with pedicle screw system and cage,which may decrease the complications such as broken screw and spondylolisthesis recurrency postoperatively.One piece of cage is enough to make interbody stable.It is also an ideal procedure for lumbar spondylolisthesis.