Khashan Morsi, Salame Khalil, Ofir Dror, Lidar Zvi, Regev Gilad J
The Department of Neurosurgery, Tel-Aviv Sourasky Medical Center, Tel-Aviv 6423906, Israel.
Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv 6423906, Israel.
Medicina (Kaunas). 2021 Nov 19;57(11):1270. doi: 10.3390/medicina57111270.
In recent literature, the routine addition of arthrodesis to decompression for lumbar spinal stenosis (LSS) with concomitant stable low-grade degenerative spondylolisthesis remains controversial. The purpose of this study is to compare the clinical outcome, complication and re-operation rates following minimally invasive (MIS) tubular decompression without arthrodesis in patients suffering from LSS with or without concomitant stable low-grade degenerative spondylolisthesis. This study is a retrospective review of prospectively collected data. Ninety-six consecutive patients who underwent elective MIS lumbar decompression with a mean follow-up of 27.5 months were included in the study. The spondylolisthesis (S) group comprised 53 patients who suffered from LSS with stable degenerative spondylolisthesis, and the control (N) group included 43 patients suffering from LSS without spondylolisthesis. Outcome measures included complications and revision surgery rates. Pre- and post-operative visual analog scale (VAS) for both back and leg pain was analyzed, and the Oswestry Disability Index (ODI) was used to evaluate functional outcome. The two groups were comparable in most demographic and preoperative variables. VAS for back and leg pain improved significantly following surgery in both groups. Both groups showed significant improvement in their ODI scores, at one and two years postoperatively. The average length of hospital stay was significantly higher in patients with spondylolisthesis (-value< 0.01). There was no significant difference between the groups in terms of post-operative complications rates or re-operation rates. Our results indicate that MIS tubular decompression may be an effective and safe procedure for patients suffering from LSS, with or without degenerative stable spondylolisthesis.
在最近的文献中，对于伴有稳定的轻度退行性椎体滑脱的腰椎管狭窄症（LSS）患者，在减压手术中常规附加关节融合术仍存在争议。本研究的目的是比较微创（MIS）管状减压术（不进行关节融合术）治疗伴有或不伴有稳定的轻度退行性椎体滑脱的LSS患者后的临床疗效、并发症及再次手术率。本研究是对前瞻性收集的数据进行回顾性分析。96例连续接受择期MIS腰椎减压术的患者纳入研究，平均随访27.5个月。椎体滑脱（S）组包括53例患有LSS并伴有稳定退行性椎体滑脱的患者，对照组（N）包括43例患有LSS但无椎体滑脱的患者。观察指标包括并发症和翻修手术率。分析了术前和术后背部及腿部疼痛的视觉模拟量表（VAS），并使用Oswestry功能障碍指数（ODI）评估功能结局。两组在大多数人口统计学和术前变量方面具有可比性。两组术后背部和腿部疼痛的VAS均显著改善。两组术后1年和2年的ODI评分均有显著改善。椎体滑脱患者的平均住院时间显著更长（P值<0.01）。两组术后并发症发生率或再次手术率无显著差异。我们的结果表明，MIS管状减压术对于患有LSS的患者，无论有无退行性稳定椎体滑脱，可能都是一种有效且安全的手术方法。
