Department of Spine Surgery, Timone Aix-Marseille University, 13006 Marseille, France; Department of Neurosurgery Timone Aix-Marseille University, 13006 Marseille, France.
Department of Spine Surgery, Timone Aix-Marseille University, 13006 Marseille, France; Department of Neurosurgery Timone Aix-Marseille University, 13006 Marseille, France.
Orthop Traumatol Surg Res. 2018 Sep;104(5):575-579. doi: 10.1016/j.otsr.2018.02.004. Epub 2018 Feb 23.
Circumferential fusion for lumbar low-grade isthmic spondylolisthesis (LGIS) provides the best spinal stability and highest fusion rates. The aim of this study is to investigate results of minimal invasive management of LGIS and correlations between Intervertebral Foramen Surface (IFS) and other parameters.
We retrospectively reviewed cases of 43 patients who underwent a minimally invasive circumferential fusion (Anterior lumbar interbody fusion followed by percutaneous posterior pedicle screw fixation) for LGIS between January 2010 and December 2014 in our institution. Inclusion criteria were one-level (L4-L5 or L5-S1) LGIS with low back and/or radicular pain. Pre- and postoperative radiographic evaluations were performed at 6, 12 and 24months. Measurements (Percentage of anterior displacement, degree of slip angle, height of the intervertebral space and the IFS) were obtained using Surgimap.
Nineteen patients (44.2%) were males. Mean age was 43 years old (19-72years). The mean follow-up of the series was 18.3months (3-72months). Mean preoperative Visual Analogy Scale (VAS) for low back pain decreased from 70mm to 20mm and from 80mm to 10mm as to radicular pain. Anterior displacement was reduced from 18% to 7% (p<0.01), degree of slippage were increased from 9.8° to 15.2° (p<0.01), intervertebral height was restored from 4.4mm to 8.5mm (p<0.01) and increase of the IFS was calculated 48.8%.
One stage circumferential fixation for adults' LGIS without decompression, allows restoration of intervertebral height permitting good reduction of the slippage, an increasing of the IFS and liberation of nerve roots.
对于腰椎低度峡部裂性滑椎（LGIS），环形融合可提供最佳的脊柱稳定性和最高的融合率。本研究旨在探讨微创治疗 LGIS 的结果，以及椎间孔表面（IFS）与其他参数之间的相关性。
我们回顾性分析了 2010 年 1 月至 2014 年 12 月期间在我院接受微创环形融合（前路腰椎椎间融合联合经皮后路椎弓根螺钉固定）治疗的 43 例 LGIS 患者的病例。纳入标准为单节段（L4-L5 或 L5-S1）LGIS 伴下腰痛和/或根性痛。在术后 6、12 和 24 个月进行影像学评估。使用 Surgimap 测量术前和术后的放射学评估结果（前移位百分比、滑脱角度、椎间隙高度和 IFS）。
男性 19 例（44.2%），平均年龄 43 岁（19-72 岁），平均随访时间为 18.3 个月（3-72 个月）。患者术前腰痛视觉模拟评分（VAS）从 70mm 降至 20mm，根性痛从 80mm 降至 10mm。前移位从 18%减少到 7%（p<0.01），滑脱角度从 9.8°增加到 15.2°（p<0.01），椎间隙高度从 4.4mm 恢复到 8.5mm（p<0.01），椎间孔面积增加 48.8%。
对于成人 LGIS，一期环形固定无需减压，可恢复椎间隙高度，有效减少滑脱，增加椎间孔面积，释放神经根。
