Gavaskar Ashok S, Achimuthu Rajamani
Mahatma Gandhi Medical College, Puducherry, Tamilnadu, India.
J Spinal Disord Tech. 2010 May;23(3):162-5. doi: 10.1097/BSD.0b013e31819fdd9f.
Prospective, nonrandomised, single center.
To study the clinico-radiologic and functional outcome after transfacetal screw fixation and fusion for low-grade degenerative spondylolisthesis of the lumbar spine.
Surgery for degenerative spondylolisthesis conventionally involves instrumented fusion using 3 column pedicle screw fixation systems. Recently transfacetal fusion techniques have been reported to produce good results without the surgical morbidity associated with posterolateral fusion and the neurologic complications associated with pedicle screw fixation.
30 patients with low-grade degenerative spondylolisthesis of the lumbar and lumbosacral spine underwent transfacetal fusion using 2 cortical screws and local cancellous bone grafts.
Clinical and radiologic evidence of fusion was obtained in 29 patients. One patient developed pseudoarthrosis with progression of slip and was reoperated. Quadruple visual analog scores and Oswestry disability assessment showed a significant improvement at 1-year follow-up.
Degenerative spondylolisthesis with lower grade slips and normal anterior structures represent an ideal indication for transfacetal fusion. This is a simple and useful technique for short segment fusions of the lumbar spine.
前瞻性、非随机、单中心研究。
研究经关节螺钉固定融合术治疗腰椎低度退变性椎体滑脱的临床、放射学及功能结局。
退变性椎体滑脱的手术传统上采用三柱椎弓根螺钉固定系统进行器械融合。最近有报道称，经关节融合技术取得了良好的效果，且没有与后外侧融合相关的手术并发症以及与椎弓根螺钉固定相关的神经并发症。
30例腰椎及腰骶部低度退变性椎体滑脱患者采用2枚皮质骨螺钉及局部松质骨植骨进行经关节融合术。
29例患者获得了融合的临床及放射学证据。1例患者发生假关节形成且滑脱进展，接受了再次手术。四分量表视觉模拟评分及Oswestry功能障碍评估显示，在1年随访时显著改善。
低度滑脱且前方结构正常的退变性椎体滑脱是经关节融合术的理想适应证。这是一种用于腰椎短节段融合的简单且有用的技术。
