Coordinación de Investigación. Instituto Nacional de Rehabilitación «Dr. Luis Guillermo Ibarra Ibarra». Av. México-Xochimilco 289, C.P. 14389. Ciudad de México. México.
Instituto Nacional de Rehabilitación «Dr. Luis Guillermo Ibarra Ibarra». Av. México-Xochimilco 289, C.P. 14389. Ciudad de México. México.
Acta Ortop Mex. 2020 Nov-Dec;34(6):433-440.
There are various approaches and surgical techniques with the objective of nerve root decompression, restrict mobility, and fusion of the listhesis. Among the techniques, posterior interbody fusion combines direct and indirect root decompression with the fusion between vertebral bodies, placing an autologous bone graft between transverse apophysis and vertebral bodies. Transforaminal lumbar and posterior interbody fusion, on the same way, look to decompress and fuse but with a different approach to the spine. The anterior approach for interbody fusion provides a better fusion rate. Lateral lumbar interbody fusion is considered less invasive, with an anterolateral transpsoas approach. The lumbar fusion technique in degenerative spondylolisthesis must be individualized. Non-fusion decompression is considered a less invasive procedure. Various studies suggest that decompression has better results when fusion is added. Surgery had several potential benefits and greater improvement in those patients who fail conservative management. An optimal technique is not conclusively identified.
有多种方法和手术技术可实现神经根减压、限制活动和滑脱融合。在这些技术中，后路椎体间融合术将直接和间接神经根减压与椎体间融合相结合，在横突和椎体之间放置自体骨移植物。经椎间孔腰椎和后路椎体间融合术同样旨在减压和融合，但采用了不同的脊柱入路。前路椎体间融合术提供了更好的融合率。侧路腰椎椎体间融合术被认为是一种侵袭性较小的方法，采用经前路腰大肌外侧入路。退行性腰椎滑脱症的腰椎融合技术必须个体化。非融合减压术被认为是一种侵袭性较小的手术。多项研究表明，融合可使减压术获得更好的效果。对于那些经保守治疗失败的患者，手术有几个潜在的益处，可带来更大的改善。目前还没有确定哪种技术是最佳的。
