Modified procedure of instrumented posterior lumbar interbody fusion for isthmic spondylolisthesis
- VernacularTitle:椎间隙撑开在腰椎滑脱症复位和融合中的应用价值
- Author:
Shunwu FAN
;
Xiangqian FANG
;
Hongjun ZHANG
- Publication Type:Journal Article
- Keywords:
Lumbar vertebrae;
Spondylolysis;
Spinal fusion;
Bone transplantation
- From:
Chinese Journal of Orthopaedics
2000;0(02):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the special roles of modified procedure of instrumented posterior lumbar interbody fusion (PLIF) for the treatment of the isthmic lumbar spondylolisthesis. Methods Surgical procedure was modified. The definitive reduction of the spondylolisthesis using pedicle screw instrumentation was followed by primary reduction using intervertebral disc space distraction and interbody fusion with insert cages and local morselized bone after decompressive laminectomy. A prospective, single-cohort, observational study of the clinical outcomes and radiological data, was assessed in a series of 46 patients with isthmic spondylolisthesis who underwent surgery from January 1999 to February 2004. The clinical outcomes were evaluated according to Oswestry disability questionnaire, and the radiographic data included slipping degree, slipping angle and posterior height of intervertebral disc. Thin-section helical computed tomography (CT) scanning was used in 5 cases post-operatively to assess the interbody fusion. Results Post-operatively, the slipping degree reduced, the posterior heights of intervertebral space increased and slipping angle decreased. The radiographic data had no obvious loss in mean follow-up time of 36 months (range, 12-73 months). Thin-section helical CT study clearly demonstrated the radiographic presence or absence of bridging bone, and solid bony fusion could be obtained at least one year after operation. The objective clinical outcomes of the Oswestry disability questionnaire were in average 33.6?6.4 before operation and 17.6?5.5 after operation. Conclusion The modified procedure as described offers advantages for isthmic spondylolisthesis, not only in substantial deformity correction, but also in suitable interbody cages choosen and normal sagital plane alignment restoration.
