Orthopedics Department, Centro Hospitalar São João, Porto, Portugal.
MEDCIDS - Faculty of Medicine, University of Porto, Porto, Portugal.
Eur Spine J. 2019 Jul;28(7):1743-1749. doi: 10.1007/s00586-018-5833-4. Epub 2018 Nov 26.
To describe and analyze the use of the V-rod technique described by Gillet to repair spondylolysis in both early and late postoperative periods.
Patients submitted to surgical correction of lumbar spondylolysis with a V-rod system were selected upon exclusion of adjacent disk degenerative changes and high-grade spondylolisthesis. A preoperative clinical (ODI and VAS) and radiological evaluation was performed, along with assessments on the early (clinical evaluation-up to 1 year) and late (clinical and radiological-at least 10 years) postoperative periods.
Twenty-two patients were included, 21 with L5 spondylolysis. Fifty percent had grade I spondylolisthesis. A significant decrease in ODI and VAS was observed from pre- to early and late post-op evaluation (all p < 0.05) but not during post-op evaluations. Changes from pre- to postoperative of both ODI and VAS were significantly higher than the minimal clinically important difference. Preoperative ODI and VAS were significantly higher in overweight/obese but similar postoperatively. No additional instability was found in late postoperative X-rays. Three patients needed revision surgery, with a survival rate of 81.8% for Gillet instrumentation at a mean follow-up of 687.7 ± 60.0 weeks.
Surgical treatment with V-rod system is associated with a significant improvement in ODI and VAS and radiologic stability, with an equal benefit in obese/overweight patients. This study reports for the first time an improvement that is maintained even 10 years after the initial intervention, associated with a low rate of failure. These slides can be retrieved under Electronic Supplementary Material.
描述和分析吉尔（Gillet）描述的 V 型棒技术在腰椎峡部裂的早期和晚期术后的应用。
选择接受 V 型棒系统治疗腰椎峡部裂的患者，排除相邻椎间盘退行性改变和高度滑脱。进行术前临床（ODI 和 VAS）和影像学评估，并在早期（临床评估-1 年内）和晚期（临床和影像学-至少 10 年）术后进行评估。
共纳入 22 例患者，其中 21 例为 L5 峡部裂。50%患者存在 I 度滑脱。从术前到早期和晚期术后评估，ODI 和 VAS 均显著下降（均 p<0.05），但术后评估期间无显著变化。术前 ODI 和 VAS 的变化均明显高于最小临床重要差异。超重/肥胖患者术前 ODI 和 VAS 明显更高，但术后相似。晚期术后 X 线片未发现额外的不稳定性。3 例患者需要翻修手术，Gillet 器械的生存率为 81.8%，平均随访 687.7±60.0 周。
V 型棒系统的手术治疗与 ODI 和 VAS 的显著改善和影像学稳定性相关，对超重/肥胖患者也有同等获益。本研究首次报道了即使在初始干预后 10 年仍保持改善的结果，失败率较低。这些幻灯片可在电子补充材料中检索。
