Boos N, Marchesi D, Aebi M
Department of Orthopaedic Surgery, University of Bern, Inselspital, Switzerland.
J Spinal Disord. 1991 Dec;4(4):472-9. doi: 10.1097/00002517-199112000-00011.
We treated 50 consecutive patients with Cotrel-Dubousset instrumentation (CDI) for symptomatic spondylolisthesis. Average follow-up was 25 months. Fusion in situ was performed in 32 of 44 patients with mild spondylolisthesis, while 12 patients had reduction in conjunction with neural decompression. Two of six patients with severe spondylolisthesis who were treated via a single posterior approach had loss of reduction and nonunion. In another patient a Grade III spondylolisthesis could not be reduced via a posterior approach. Seventy-six percent of the patients had a good clinical result. The rate of solid fusion was 96%. One nerve root compromise recovered completely. One superficial wound infection healed uneventfully. This study suggests that combined anterior and posterior fusion is required for permanent and sufficient correction of severe spondylolisthesis even with CDI. Low-grade spondylolisthesis should be reduced only in conjunction with neural decompression.
我们对50例有症状的腰椎滑脱患者采用Cotrel-Dubousset器械（CDI）进行了连续治疗。平均随访时间为25个月。44例轻度腰椎滑脱患者中有32例行原位融合，12例在神经减压的同时进行了复位。6例重度腰椎滑脱患者中，2例经单一后路手术治疗后出现复位丢失和不愈合。另有1例Ⅲ度腰椎滑脱患者经后路手术无法复位。76%的患者临床效果良好。坚固融合率为96%。1例神经根损伤完全恢复。1例表浅伤口感染顺利愈合。本研究表明，即使使用CDI，对于重度腰椎滑脱的永久性和充分矫正仍需要前后路联合融合。低度腰椎滑脱仅应在神经减压的同时进行复位。
