Clinical study of different surgical procedures for the treatment of lumbar spondylolisthesis:clinical analysis on 82 cases / 中国矫形外科杂志

ABSTRACT

[Objective]Through the analysis of 82 cases of spondylolisthesis treated with surgery,the different types of surgical procedures were evaluated.[Method]Patients with spondylolisthesis were divided into 4 groups based on their pathology and different surgical procedures were used accordingly.Group Ⅰ consisted of 18 patients with degenerative spondylolisthesis with back pain(3 cases)and isthmic spondylolisthesis(13 cases)and traumatic spondylolisthesis(2 cases)of Ⅰ degree;They were treated with posterior interlaminar and interspinous process fusion;Group Ⅱ consisted of 31 cases with degenerative spondylolisthesis(2 cases)and isthmic spondylolisthesis(23 patients)and traumatic spondylolisthesis(6 cases)of Ⅰ degree(11 cases)and Ⅱ degree(20 cases);They were treated with reduction of sliding vertebra and posterior interlaminar and interspinous process fusion;Group Ⅲ consisted of 19 cases with degenerative spondylolisthesis(2 cases)and isthmic spondylolistbesis(17 cases)of Ⅰ degree(2 cases),Ⅱ degree(13 cases)and Ⅲ degree(4 cases);They were treated with laminectomy and decompression,with reduction of sliding vertebra and transverse process fusion;Group Ⅳ consisted of 14 cases with isthmic spondylolisthesis of Ⅰ degree(1 case),Ⅱ degree(10 cases)and Ⅲ degree(3 cases);They were treated with laminectomy and decompression,with intervertebral body fusion,with reduction of sliding vertebra and transverse process fusion.[Result]In group Ⅰ,solid fusion were in 15 cases giving a fusion rate of 83%,0.03% rate of reduction,52.69% rate of improvement;In group Ⅱ,solid fusion were in 30 cases giving a fusion rate of 96%,56.20% rate of improvement,83% rate of reduction;In group Ⅲ,fusion rate,reduction rate and improvement rate reached 89%,90%,59.85% respectively;In group Ⅳ,the fusion rate,reduction rate and improvement rate were as high as 100%,92%,61.08% respectively.[Conclusion]Different operative methods have different operative indications.Operative methods differ from different patients.