Saleh Ifran, Librianto Didik, Dilogo Ismail Hadisoebroto, Supriadi Sugeng, Indriatmi Wresti, Octaviana Fitri, Prasetyo Marcel, Noor Zairin
Orthopaedic Spine Surgeon, Department of Orthopaedic and Traumatology, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo Hospital, Jakarta Pusat, Indonesia.
Orthopaedic Spine Surgeon, Department of Orthopaedic and Traumatology, Faculty of Medicine Universitas Indonesia - Fatmawati Hospital, Jakarta Pusat, Indonesia.
Orthop Res Rev. 2022 Oct 28;14:365-372. doi: 10.2147/ORR.S382232. eCollection 2022.
Until now, the spondylolisthesis reduction technique has relied on posterior instrumentation using long arm pedicle screws. In this way, the segments will be brought into alignment with the other vertebrae with the pedicle mats being tightened. The aim of this study is to acknowledge whether reduction surgery for degenerative lumbar spondylolisthesis (DLS) using long arm pedicle screws is able to correct the listhesis and spinopelvic parameters.
We carried out a retrospective study of patients with degenerative lumbar spondylolisthesis who went through reduction surgery using long arm pedicle screws in our institutions from January 2019 to March 2022. Preoperative and postoperative radiological outcomes consisting of listhesis and spinopelvic parameters were assessed.
We found a statistical difference between the magnitude of listhesis immediately after surgery and preoperatively (p<0.001), with a successful correction of 85.85%. There was significant decrease in the value of pelvic tilt (p=0.044) and increase in the value of sacral slope (p=0.008) after surgery.
Reduction surgery using long arm pedicle screws for DLS was able to reduce the listhesis effectively up to 85.5%, and also to restore the parts of spinopelvic parameters, the pelvic tilt and sacral slope, approaching normal values.
到目前为止，腰椎滑脱复位技术一直依赖于使用长臂椎弓根螺钉的后路内固定。通过这种方式，随着椎弓根垫收紧，各节段将与其他椎体对齐。本研究的目的是确认使用长臂椎弓根螺钉对退变性腰椎滑脱（DLS）进行复位手术是否能够纠正滑脱和脊柱骨盆参数。
我们对2019年1月至2022年3月在我们机构接受使用长臂椎弓根螺钉复位手术的退变性腰椎滑脱患者进行了一项回顾性研究。评估了包括滑脱和脊柱骨盆参数在内的术前和术后放射学结果。
我们发现术后即刻与术前的滑脱程度存在统计学差异（p<0.001），成功矫正率为85.85%。术后骨盆倾斜度值显著降低（p=0.044），骶骨倾斜度值显著增加（p=0.008）。
使用长臂椎弓根螺钉对DLS进行复位手术能够有效减少滑脱达85.5%，还能恢复部分脊柱骨盆参数，即骨盆倾斜度和骶骨倾斜度，使其接近正常值。
