Vanden Berghe L, Maes G, Fabry G, Hoogmartens M
Department of Orthopaedic Surgery, University Hospital, Pellenberg, Belgium.
Acta Orthop Belg. 1991;57 Suppl 1:214-8.
In this series spondylolisthesis was treated operatively in children and adolescents who had a displacement greater than 50% even if they were asymptomatic. In youngsters with less than 50% displacement and in adults, operative stabilization was performed if the displacement was progressive or if there were persistent symptoms unresponsive to conservative treatment that interfered with the patient's normal activities. The operation consisted of a posterolateral fusion in situ. Usually a laminectomy was not performed unless there were signs of severe neural compression. No reduction of the spondylolisthesis was attempted. We reviewed 38 cases treated operatively with a mean follow-up of 7 years. Twenty patients were younger than 20 years at the time of operation and 10 of these had greater than 50% displacement. The results were good to excellent in 90% (18 patients). In the adult group (18 cases) the results were less favorable, but still good to excellent in 72% (13 patients). In the adult group pseudarthrosis frequently occurred at the L4-L5 level. There were no neurologic complications postoperatively. Fusion in situ for spondylolisthesis is a safe operation giving satisfactory results.
在本系列研究中，对于移位超过50%的儿童和青少年腰椎滑脱患者，即便无症状也进行手术治疗。对于移位小于50%的青少年及成人患者，若移位呈进行性或存在对保守治疗无反应且干扰患者正常活动的持续症状，则进行手术固定。手术包括原位后外侧融合术。除非有严重神经受压迹象，通常不进行椎板切除术。不尝试对腰椎滑脱进行复位。我们回顾了38例接受手术治疗的病例，平均随访7年。20例患者手术时年龄小于20岁，其中10例移位超过50%。90%（18例患者）的结果为良好至优秀。在成人组（18例）中，结果稍差，但仍有72%（13例患者）为良好至优秀。成人组中，假关节常发生于L4-L5节段。术后无神经并发症。腰椎滑脱原位融合术是一种安全的手术，效果令人满意。
