Kotil Kadir
Department of Neurosurgery, T.C. Istanbul Arel University, School of Medicine, Istanbul, Turkey.
Asian Spine J. 2016 Jun;10(3):443-9. doi: 10.4184/asj.2016.10.3.443. Epub 2016 Jun 16.
A review of clinical and radiological outcomes of lumbar laminoplasty (LL) for the treatment of isthmic spondylolisthesis (ISL).
The single session performance of posterior lumbar interbody fusion with allograft in the anterior column and providing the realignment of the vertebrae was presented as a preliminary report earlier.
Long-term surgical outcome of cervical laminoplasty in patients has been reported. But, outcome of LL in patients is unclear.
The long-term (5 years) year follow-up results of the LL technique are reported in this retrospective study. All patients underwent preoperative and postoperative direct X-ray, computed tomography, and magnetic resonance imaging. The patients that did not respond to conservative treatment were operated. Twenty-one (52.5%) female and 19 (47.5%) male patients were included.
Mean age was 43,5 years (ranges, 22-57 years). The most common symptoms were low back pain (89%), pelvic and leg pain (69%) and reduction in walking distance (65%). A total of 180 pedicle screws were inserted in 40 patients; posterior lumbar interbody fusion and laminoplasty with reduction was performed in 20 patients for L4-L5, 12 patients for L5-S1, 4 patients for L3-L4-L5 and 4 patients for L4-L5-S1. Ten (25%) patients with ILL had accompanying spinal stenosis. The difference between preoperative and postoperative sagittal plane rotation and dislocation degrees and disc space heights were statistically significant in all patients (p<0.05). Solid grade 4 fusion was observed in 38 patients; in only 2 patients grade 2 pseudoarthrosis developed (5%), but these patients were asymptomatic. Visual analog scale, Prolo economical and functional scale was examined with an average follow-up 5.5 years.
LL technique has the advantages of shorter duration of operation, lack of graft donor site complications, protection of posterior column osseoligamentous structures and achievement of high fusion rates in one session.
对腰椎板成形术（LL）治疗峡部裂性脊椎滑脱（ISL）的临床和放射学结果进行综述。
先前曾有初步报告介绍了在前柱采用同种异体骨进行后路腰椎椎间融合并实现椎体重新排列的单次手术效果。
已有关于患者颈椎板成形术长期手术结果的报告。但是，LL治疗患者的结果尚不清楚。
本回顾性研究报告了LL技术的长期（5年）随访结果。所有患者均接受术前和术后直接X线、计算机断层扫描和磁共振成像检查。对保守治疗无效的患者进行手术。纳入21名（52.5%）女性和19名（47.5%）男性患者。
平均年龄为43.5岁（范围22 - 57岁）。最常见的症状是腰痛（89%）、骨盆和腿部疼痛（69%）以及行走距离缩短（65%）。40例患者共植入180枚椎弓根螺钉；20例患者在L4 - L5节段、12例患者在L5 - S1节段、4例患者在L3 - L4 - L5节段以及4例患者在L4 - L5 - S1节段进行了后路腰椎椎间融合和复位椎板成形术。10例（25%）ILL患者伴有椎管狭窄。所有患者术前和术后矢状面旋转和移位程度以及椎间盘间隙高度的差异具有统计学意义（p<0.05）。38例患者观察到坚固的4级融合；仅2例患者出现2级假关节形成（5%），但这些患者无症状。采用视觉模拟量表、普罗洛经济和功能量表进行检查，平均随访5.5年。
LL技术具有手术时间短、无移植供区并发症、保护后柱骨韧带结构以及单次手术实现高融合率等优点。
