Song DeYong, Song DeWei, Zhang KeHui, Chen Zhong, Wang Feng, Xuan TianHang
Department of Spine Surgery, Foshan Hospital of Traditional Chinese Medicine, Foshan City, Guangdong Province, China.
Department of Minimally invasive pain treatment, Mengyin County Hospital, Linyi City, Shandong Province, China.
Clin Neurol Neurosurg. 2017 Oct;161:35-40. doi: 10.1016/j.clineuro.2017.08.007. Epub 2017 Aug 19.
The incidence of double-level isthmic spondylolisthesis is rare. The aim of this study is to evaluate the short-term functional and radiological outcomes of surgical treatment for double-level isthmic spondylolisthesis.
Between 2004 and 2014, thirty-two patients with double-level isthmic spondylolisthesis who underwent posterior lumbar interbody fusion (PLIF) with autogenous bone chips were reviewed retrospectively. The clinical outcomes were measured by VAS (Visual analog scale) and JOA(Japanese Orthopedic Association) score.
At an average follow-up of 2.8 years, the mean score on the VAS of back pain and sciatica decreased from 6.48 and 4.26 points preoperatively to 1.82 and 1.10 points at final follow-up, respectively. The average JOA score improved from 13.8±3.1 preoperative to 25.6±1.3 (range, 17-28) points postoperative. The average recovery rate was 77.6%. The good and excellent rate was 84.3% (27/32). The fusion rate was 87.5% (28/32). Changes in disc height, degree of listhesis, whole lumbar lordosis, and sacral inclination between the pre- and postoperative periods were significant.
Our findings suggest that PLIF with autogenous bone chips for double-level isthmic spondylolisthesis could yield good functional short-term results. It seems to be a viable approach in the treatment of double-level isthmic spondylolisthesis.
双节段峡部裂型腰椎滑脱症的发病率较低。本研究旨在评估双节段峡部裂型腰椎滑脱症手术治疗的短期功能和影像学结果。
回顾性分析2004年至2014年间32例行后路腰椎椎间融合术(PLIF)并植入自体骨块的双节段峡部裂型腰椎滑脱症患者。通过视觉模拟评分法(VAS)和日本骨科协会(JOA)评分来衡量临床结果。
平均随访2.8年,背痛和坐骨神经痛的VAS平均评分分别从术前的6.48分和4.26分降至末次随访时的1.82分和1.10分。JOA平均评分从术前的13.8±3.1分提高到术后的25.6±1.3分(范围17 - 28分)。平均恢复率为77.6%。优良率为84.3%(27/32)。融合率为87.5%(28/32)。术前和术后间盘高度、滑脱程度、腰椎前凸角和骶骨倾斜度的变化均具有显著性。
我们的研究结果表明,双节段峡部裂型腰椎滑脱症采用自体骨块行PLIF可获得良好的短期功能结果。这似乎是治疗双节段峡部裂型腰椎滑脱症的一种可行方法。