Department of Orthopedics, University Hospital, Lund, Sweden.
Eur Spine J. 1992 Sep;1(2):100-4. doi: 10.1007/BF00300935.
The incidence and magnitude of vertebral slipping after decompression for central lumbar spinal stenosis were determined in a prospective study of 60 consecutive patients. Mean patient age was 64 (35-83) years, and 35 patients were men. In all cases, laminectomy was performed using a facet joint preserving undercutting technique. Plain radiographs were obtained before and 1 year after surgery. Vertebral slipping and disc degeneration were measured. Preoperative degenerative olisthesis was seen in 19 of the 60 patients. Further slipping had occurred in 6 of these patients by 1 year postoperatively. Of the remaining 41 patients, only 1 showed a postoperative slipping. Improvement concerning leg pain was reported by 45 patients, and there was no difference in patients with or without postoperative slipping. It is concluded that decompression with a facet joint preserving technique yielded a low risk for postoperative vertebral slipping. The risk for slip was higher in patients with preoperative degenerative olisthesis but was still less than 1/3. Vertebral slipping did not influence the outcome of the operation at 1 year. Our results do not support the routine use of spinal fusion in connection with decompression for lumbar spinal stenosis.
前瞻性研究了 60 例连续患者，确定了减压治疗中央型腰椎椎管狭窄症后椎体滑移的发生率和程度。平均患者年龄为 64（35-83）岁，35 例为男性。所有病例均采用保留关节突关节的下切技术进行椎板切除术。术前和术后 1 年均进行了 X 线平片检查。测量了椎体滑移和椎间盘退变的情况。60 例患者中有 19 例术前存在退行性滑脱。术后 1 年内，其中 6 例进一步出现滑脱。在其余 41 例患者中，仅 1 例出现术后滑脱。45 例患者报告腿部疼痛有所改善，且有无术后滑脱的患者之间无差异。因此，采用保留关节突关节技术减压术后发生椎体滑移的风险较低。术前存在退行性滑脱的患者发生滑脱的风险较高，但仍低于 1/3。术后 1 年时，椎体滑移并不影响手术结果。我们的结果不支持常规在减压治疗腰椎管狭窄症时使用脊柱融合术。
