Porous beta-tricalcium phosphate bone graft fusion for repair of degenerative lumbar spondylolisthesis：a comparison of vertebral fusion ratesviadifferent appraches / 中国组织工程研究

ABSTRACT

BACKGROUND:In recent years, pedicle internal fixation, spinal canal decompression and bone graft fusion have been used in the treatment of degenerative lumbar spondylolisthesis complicated by lumbar spinal stenosis and have achieved good results, which increase the fusion rate. However, there is a large difference between the therapeutic effects of different surgical methods. OBJECTIVE:To contrast the repair effect of posterior and transforaminal lumbar interbody fusion on degenerative lumbar spondylolisthesis complicated by lumbar spinal stenosis. METHODS:Forty patients with degenerative lumbar spondylolisthesis complicated by lumbar spinal stenosis were enroled, including 11 males and 29 females, aged 56-74 years. Al patients received the combined treatment of pedicle internal fixation, spinal canal decompression and bone graft fusion. The 19 of 40 patients received posterior lumbar interbody fusion and the rest 21 patients underwent transforaminal lumbar interbody fusion. Al the patients were folowed up for 6 months after treatment, and the visual analog scores, Oswestry function index, bone fusion rate, lumbar function score and complication occurrence were analyzed and compared between the two groups. RESULTS AND CONCLUSION:The visual analog scores and Oswestry function index were both improved significantly in the two groups at 6 months after treatment (P < 0.05). No difference was found in the bone fusion rate, visual analog scores and Oswestry function index between the two groups. But compared with the posterior lumbar interbody fusion group, the lumbar functional recovery and incidence of complications were better in the transforaminal lumbar interbody fusion group (P < 0.05). These findings indicate that both posterior and transforaminal lumbar interbody fusions for degenerative lumbar spondylolisthesis complicated by lumbar spinal stenosis can achieve good results in the bone fusion rate, and however, the transforaminal lumbar interbody fusion is better to protect the nerve root and dural sac and to promote lumbar functional recovery.