[The height of intervertebral foramen in operative treatment of isthmic spondylolisthesis]. / Wysokosc otworu miedzykregowego w operacyjnym leczeniu kregozmyku ciesniowego.

49 patients with spondylolisthesis isthmica were treated in the years 1991-2006. The age of patients varied between 21 and 65 years, 43.7 year on average. Two stages operative protocol consisted of reduction of the slip by pedicular implant and anterior interbody fusion with the cages was used. The evaluation was based on x-rays height of the lumbar intervertebral foramen and posterior disc height in the 2 distal lumbar vertebrae pre and post operatively. This results showed clearly a decrease of both these values on the level of the slip, demonstrating the lumbar intervertebral stenosis. Te operative procedure decomprssed the lumbar intervertebral foramen and increased both values evaluated Postoperatively in the neighbor vertebrae a height lumbar intervertebral foramen was increased but posterior disc height a unchanged.

[The results of decompression and anterior lumbar interbody fusion with the use of interbody cages for the treatment of degenerative lumbar spondylolisthesis]. / Zastosowanie przedniego usztywnienia kregoslupa z uzyciem czopów miedzytrzonowych w leczeniu kregozmyku zwyrodnieniowego.

In this paper we reviewed 28 patients who had been treated surgically for lumbar degenerative spondylolisthesis. They were operated between 1998-2003. The decompression and anterior lumbar interbody fusion with the use of interbody cages, was performed in all of them. The outcome was assessed using rating system of Prolo and VAPS. The disc height, degree of slippage and segmental lordosis were measured, on the radiographs, before surgery, after 6 weeks and at the time of final follow-up. In all cases spinal fusion was achieved. The disc height, degree of slipage and segmental lordosis were improved and these results were stable in time. A significant decrease in radicular pain and low back pain were seen but the relation between clinical and radiological autcomes was not observed.

[In vitro assessment of the lumbo-sacral spine after posterior transpedicular stabilization and anterior cage implantation]. / Badanie doswiadczalne stabilizacji kregoslupa ledzwiowo-krzyzowego po zastosowaniu tylnej stabilizacji przeznasadowej i przednich klatek miedzytrzonowych.

The biomechanical tests were performed on 9 cadaver specimens of lumbo-sacral spine. The specimens consisted of two lumbar motion segments, sacral bone together with the sacroiliac joint and parts of pelvis. The goal of the biomechanical tests was to estimate the motion of the lumbar spine, which was stabilised by the transpedicular implant and by the intervertebral cages. The tests showed that the traspedicular stabilisation is more effective than inervetebral with cages.

[Anterior and posterior stabilization of the lumbosacral spine with the usage of interbody cages in the operational treatment of the isthmic spondylolisthesis]. / Przednia i tylna stabilizacja kregoslupa ledzwiowo-krzyiowego z uzyciem klatek miedzytrzonowych w operacyjnym leczeniu kregozmyku ciesniowego.

In the following work results of the operational treatment of the isthmic spondylolisthesis by the posterior stabilization and anterior lumbosacral interbody fusion with the use of interbody implants--cages was taken under evaluation. The test group consisted of 21 patients (13 male and 8 male). The follow up period exceeded 2 years. The objective clinical outcome assessment was based on Oswestry disability questionnaire. Subjective clinical evaluation was done by the visual analog pain score and two questions concerning the evaluation of success of the operative treatment and a possible agreement to a following operation if necessary. The radiological results were done upon evaluation of the degree of the spondylolisthesis, the angle of the lumbosacral lordosis, the height of the interbody space and intervertebral foramen and the evaluation of the spinal fusion. The conclusion was that the usage of the distraction of the lumbosacral spine in the operational treatment of the isthmic spondylolisthesis result in the reduction of the slippage and the dynamic decompression of the compressed neural roots. The usage of the interbody cages prevented the loss of slippage correction, permanently reconstructed the anatomical conditions in the area of the operated spinal segment and helped to achieve good and very good clinical results in over 95% of patients. The fusion rate was 100%. The restoration of the correct height of the intervertebral foramen in the slip segment caused an improvement of the neurologic state. The usage of two level stabilization in the operative treatment of the isthmic spondylolisthesis prevented the initiation of the secondary degenerative changes adjacent to the fusion.

[The long-term results of decompression and anterior lumbar interbody fusion for the treatment of degenerative lumbar spondylolisthesis]. / Odlegle wyniki leczenia kregozmyków zwyrodnieniowych metoda odbarczenia z tylna stabilizacja, i przednim miedzytrzonowym usztywnieniem.

In this paper we reviewed 31 patients who had been treated surgically for lumbar degenerative spondylolisthesis. They were operated between 1990-1996. The decompression and anterior lumbar interbody fusion with use of autologous bone graft,was performed in all of them. The duration of follow-up ranged from 12 to 6 years. The outcome was assessed using rating system of Prolo and VAPS. The disc high, degree of slippage, segmental lordosis, before surgery, after 6 weeks and at the time of final follow-up were measured on the radiographs. In all cases spinal fusion were achieved. A significant decrease in radicular pain and low back pain was seen but the relation between clinical and radiological outcomes was not observed.

[The influence of the morphology of intervertebral facet joints on the development of the degenerative spondylolisthesis]. / Wplyw budowy stawów miedzykregowych w odcinku ledzwiowym na powstawanie kregozmyku zwyrodnieniowego.

In this paper, the influence of the orientation of intervertebral facet joints in segment L4-L5 on the development of degenerative spondylolisthesis is presented. Thirty one patients over 45 years old, who were operated because of back pain in spondyloarthrosis, were analyzed. All patients were divided into two groups. The first group consisted of the patients with degenerative spondylolisthesis at the level L4-L5. The second group consisted of the patients who were operated because of stenosis without instability at L4-L5. The significant differences in the sagittal orientation of facet joints were stated. We confirmed that the presence of more sagittaly orientated facet joints has influence on degenerative spondylolisthesis. Lack of the increase in value of this angle in patients with degenerative changes without instability allows to suppose that this process is not the result of arthritic remodeling.