Laurent L E, Osterman K
Clin Orthop Relat Res. 1976 Jun(117):85-91.
In a series of 91 patients under 20 years of age with lytic spondylolisthesis treated by different operations, 66 (73%) showed a displacement of more than 30 per cent at admission. If the displacement exceeds 30 per cent, it often progresses to a subtotal olisthesis. Spinal fusion should be performed before the displacement exceeds a third of the length of the vertebra. A posterior fusion with two massive tibial grafts was carried out in 78 patients (87.5%). Concurrent with fusion laminectomy was performed in 18 patients. Anterior vertebral body fusion was performed in 3 patients and posterolateral fusion in 10, in 4 of these as a secondary operation. Laminectomy alone was carried out in 4 patients, 3 of these having a total olisthesis. Laminectomy without fusion should be performed only in exceptional cases in young patients. Non-union or uncertain union after the primary operations occurred in 17 cases (19.5%); 15 reoperations were performed in 13 patients. The degree of displacement at operation did not influence the results. A progression of displacement despite dorsal fusion was observed in 14 patients. The final results of operative treatment were: good in 55 patients (60.4%); satisfactory in 23 (24.1%); unsatisfactory in 13 (15.5%). Posterolateral fusion seems to be preferable to posterior fusion.
在一组91例20岁以下因椎体溶解性滑脱接受不同手术治疗的患者中，66例（73%）入院时移位超过30%。如果移位超过30%，常常会进展为次全椎体滑脱。椎体融合应在移位超过椎体长度的三分之一之前进行。78例患者（87.5%）采用两块大块胫骨移植进行后路融合。18例患者在融合的同时进行了椎板切除术。3例患者进行了前路椎体融合，10例进行了后外侧融合，其中4例为二次手术。4例患者仅进行了椎板切除术，其中3例存在完全椎体滑脱。仅在年轻患者的特殊情况下才应进行不融合的椎板切除术。初次手术后出现不愈合或愈合不确定的情况有17例（19.5%）；13例患者进行了15次再次手术。手术时的移位程度不影响结果。14例患者尽管进行了后路融合仍出现了移位进展。手术治疗的最终结果为：55例患者（60.4%）良好；23例（24.1%）满意；13例（15.5%）不满意。后外侧融合似乎比后路融合更可取。
