Ghosez J P, Himmer O, Devyver B, Rossillon R, Beugnies A, Lootvoet L
Sercice d'Orthopédie, Clinique St-Luc, Bouge, Belgique.
Rev Chir Orthop Reparatrice Appar Mot. 1992;78(8):515-28.
The authors present a series of 186 cases of spondylolisthesis treated using 3 different types of arthrodesis: 84 by anterior arthrodesis, 35 by postero-lateral arthrodesis and 67 by combined arthrodesis. Slippage reduction was sought only in combined arthrodesis. The elimination of pain or a significant improvement were noted in 95 per cent of cases treated by anterior arthrodesis, in 74 per cent of those treated by postero-lateral arthrodesis and in 97 per cent of those treated by combined arthrodesis. The work resumption or professional rehabilitation rate was 89 per cent for anterior arthrodesis, 46 per cent for postero-lateral arthrodesis and 90 per cent for combined arthrodesis. Analysis of the clinical results according to the criteria of Stauffer and Coventry shows that good results were noted in 69 per cent of cases treated by anterior arthrodesis, in 43 per cent of those treated by postero-lateral arthrodesis and in 74 per cent of those treated by combined arthrodesis. A fusion rate of 86 per cent was achieved after anterior arthrodesis, 69 per cent after postero-lateral arthrodesis and 95 per cent after combined arthrodesis. Reduction had no effect on either clinical results or spinal statics in spondylolisthesis of less than 50 per cent. In the reduction of spondylolisthesis of more than 50 per cent, better results were obtained with the R. Louis technique than the Harrington technique in the restoration of spinal statics and maintenance of long-term clinical results.
作者介绍了一系列186例腰椎滑脱病例，采用了3种不同类型的关节融合术进行治疗：前路关节融合术84例，后外侧关节融合术35例，联合关节融合术67例。仅在联合关节融合术中寻求滑脱复位。前路关节融合术治疗的病例中，95%的患者疼痛消除或显著改善；后外侧关节融合术治疗的病例中，这一比例为74%；联合关节融合术治疗的病例中，这一比例为97%。前路关节融合术的工作恢复或职业康复率为89%，后外侧关节融合术为46%，联合关节融合术为90%。根据Stauffer和Coventry的标准对临床结果进行分析表明，前路关节融合术治疗的病例中，69%取得了良好效果；后外侧关节融合术治疗的病例中，这一比例为43%；联合关节融合术治疗的病例中，这一比例为74%。前路关节融合术后融合率为86%，后外侧关节融合术后为69%，联合关节融合术后为95%。对于滑脱小于50%的腰椎滑脱病例，复位对临床结果和脊柱静力学均无影响。在滑脱大于50%的复位病例中，在恢复脊柱静力学和维持长期临床结果方面，R. Louis技术比Harrington技术取得了更好的效果。
