Modified Jaslow technique for treatment of adult double-level isthmic spondylolisthesis / 第二军医大学学报

ABSTRACT

Objective To assess the surgical outcomes of double-level isthmic spondylolisthesis in adults. Methods From Mar. 2006 to Nov. 2010, 30 patients with double-level lumbar isthmic spondylolisthesis were treated with modified Jaslow technique combined with posterior lumbar interbody fusion. Clinical outcomes were assessed by Japanese Orthopedic Association (JOA) score; the functional disability was quantified by Oswestry Disability Index (ODI); the Lenke grading system was used to assess the spinal fusion; and theHenderson grading system, the intervertebral height index, and the Taillard index were used to assess the clinical outcome. Results All the 30 patients achieved reduction of different degrees, with the mean reduction rate being (43. 60±25. 29) %. The intervertebral height index was (17. 68±6. 67)% before operation, increased to (50. 99 ± 4. 94) % at 1 week after operation and (44. 37 ±5. 84) % at the last follow-up. The Taillard index was (20. 91 ± 7. 11) % before operation, (10. 23 ± 2. 16) % at1 week after operation, and (11. 87±2. 73) % at the last follow-up. The height index and the Taillard index before operation were significantly different from those of the other two time points (1 week after operation and final follow-up, P<0. 01). The bone fusion was grade A in 49 levels and grade B in 11 levels. The JOA score increased from 9. 60 ± 1. 89 before operation to 22. 40±2. 06 at 6 months after operation and 22. 70±1. 63 at the final follow-up. ODI was 34. 90±5. 56 before operation, which was decreased to 11. 80±1. 81 at 6 months after operation and 10. 70±1. 33 at the last follow-up. The JOA score and the ODI index before operation were significantly different from those of 6 months after operation and those at the final follow-up (P<0. 01). The Henderson clinical outcome was excellent in 19 cases, good in 8 cases, and poor in 3 cases. Conclusion Complete decompression, reduction of isthmic spondylolisthesis by modified Jaslow technique, pedicle screw fixation, and posterior lumbar interbody fusion can achieve satisfactory clinical results for adults with double-level isthmic spondylolisthesis.