Pedicle fixation combined with intervertebral fusion for lumbar spondylolithesis:whether restoring disc height affects the biomechanics and spinal function / 中国组织工程研究

ABSTRACT

BACKGROUND: According to the current most prevailed posterior pedicle screw reduction and Cage fusion for spondylolisthesis, the previous focus is to restore the vertebral sagittal displacement, and whether restoring disc height is needed and the degree of recovery remain unclear. Moreover, there is still a lack of better quantitative indicators to restore the disc height.OBEJCTIVE By comparing the surgery of lifting reduction, to study the clinical effect of distraction and lifting reduction combined with posterior intervertebral fusion in the treatment of lumbar spondylolisthesis. METHODS: Sixty patients with L5 spondylolisthesis located in L5/S1 were selected, and were divided into two groups based on the surgery methods (n=30 per group) group A (single lifting reduction group) and group B (lifting and distracting reduction group). The patients in the group B were given distracting reduction amid insertion of 12 mm-height Cage; while the patients in the group A were subjected to lifting reduction, and intervertebral fusion with 8 mm-height Cage. The general information and the Visual Analogue Scale, Japanese Orthopaedic Association and Oswestry Disability Index scores at baseline, postoperative 1 month and last follow-up, as well as the postoperative correction and bone fusion were recorded. Additionally, the clinical effectiveness was assessed by Macnab score. RESULTS AND CONCLUSION: (1) At postoperative 1 month and last follow-up, the disc height, disc height/vertebral height, neuroforamen height and clinical effectiveness in the group B were superior to those in the group A (P < 0.05). (2) To conclude, the pedicle screw system combined with posterior intervertebral cage fusion for spondylolisthesis, can rapidly restore the disc height, contribute to restructure better biomechanics of spine. Furthermore, it significantly improves clinical systems, is easy to operate, and achieves better efficacy; therefore, it is recommended firstly.