Evaluation of Different Surgical Procedures for the Treatment of Lumbar Spondylolisthesis: A Clinical Analysis of 202 Cases / 中华骨科杂志

ABSTRACT

Purpose: Through the analysis of 202 cases of spondylolisthesis treated with surgery, the different types of surgical procedures were reevaluated. Material and Method: Patients with spondylolisthesis were divided into 3 groups based upon their pathology and different surgical procedures were used accordingly. The results were evaluated after follow-up of more than one year. Group Ⅰ consisted of 38 patients with degenerative spondylolisthesis with back pain and isthmic spondylolisthesis of less than 33%; they were treated with anterior intervertebral body fusion. Group Ⅱ consisted of 99 cases of mild isthmic spondylolisthesis with unilateral sciatica, and were treated with semi-laminectomy and decompression of symptomatic side; interlaminar and interspinous process fusion of the opposite side was performed for 99 cases of mild isthmic spondylolisthesis with unilateral sciatica. Group Ⅲ consisted of 65 cases of spondylolisthesis more than 33% with sciatica and they were treated with decompression, reduction of sliding vertebra and posterior intervertebral body fusion. Result: In group Ⅰ, solid fusion was in 20 cases giving a fusion rate of 91%. In group Ⅱ, the satisfactory rate was as high as 91.5%. In group Ⅲ, the satisfactory rate and fusion rate reached 91.8% and 95.9% respectively. Conclusion: Reduction of spondylolisthesis could increase the fusion contact area, restore normal mechanics and saggital curve of the lumbar spine, relieve neural compression and improve the extemal appearance and function. For the surgical treatment of spondylolisthesis, the major goal should toward a solid fusion between the sliding vertebra and its adjacent vertebrae and laminectomy alone is not a procedure of choice.