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退行性 1 度腰椎滑脱与稳定型腰椎管狭窄症的微腰椎减压临床结果分析

Analysis of the Clinical Outcome of Microlumbar Decompression in Degenerative Grade-1 Spondylolisthesis versus Stable Lumbar Canal Stenosis.

作者信息

Singh Ajaybir

机构信息

Department of Orthopedics, Guru Gobind Singh Medical College and Hospital, Baba Farid University of Health Sciences, Faridkot, Punjab, India.

出版信息

Rev Bras Ortop (Sao Paulo). 2025 Aug 18;60(3):1-7. doi: 10.1055/s-0045-1810036. eCollection 2025 Jun.

Abstract

OBJECTIVE

To assess the clinical outcomes of a non-fusion decompression procedure in degenerative low-grade spondylolisthesis versus stable lumbar canal stenosis.

METHODS

The study analyzed 50 cases of lumbar degenerative pathology that underwent decompression involving a single level. Dynamic X-ray assessment was employed to evaluate instability. Group 1 included stable lumbar stenosis, while group 2 included Meyerding grade-1 degenerative spondylolisthesis. Two years postmicrolumbar decompression, the final functional outcomes were assessed using the Oswestry Disability Index (ODI) and the Visual Analog Scale (VAS) for backache and leg pain.

RESULTS

Group 1 included 25 cases with a mean ODI of 75.36 ± 13.59, mean VAS for backache of 5.92 ± 3.45, and mean VAS for leg pain of 8.92 ± 1.81. Group 2 included 25 cases with a mean ODI of 68.75 ± 11.81, mean VAS backache of 8 ± 1.22, and mean VAS leg pain of 7.87 ± 1.57. At 2 years, group 1's mean ODI improved to 22.64 ± 17.2 (  < 0.0001), mean VAS backache reduced to 2.04 ± 1.86 (  = 0.0002), and VAS leg pain reduced to 1.56 ± 1.97 (  < 0.0001). Group 2 showed a mean ODI of 24 ± 10.6 (  < 0.0001), backache mean VAS of 2.12 ± 1.43 (  = 0.0009), and mean VAS leg pain of 2.56 ± 1.35 (  = 0.0008). Both groups showed statistically comparable functional improvement.

CONCLUSION

Microlumbar decompression yielded comparable functional outcomes in both groups. This procedure presents a viable option for preserving the integrity of lumbar motion segment in degenerative low grade (Meyerding grade 1) spondylolisthesis.

摘要

目的

评估退行性低度腰椎滑脱与稳定型腰椎管狭窄症行非融合减压手术的临床疗效。

方法

本研究分析了50例接受单节段减压的腰椎退行性病变病例。采用动态X线评估不稳定情况。第1组为稳定型腰椎管狭窄症,第2组为迈耶丁1级退行性腰椎滑脱症。在显微腰椎减压术后两年,使用Oswestry功能障碍指数(ODI)以及背痛和腿痛视觉模拟量表(VAS)评估最终功能结局。

结果

第1组25例,平均ODI为75.36±13.59,背痛平均VAS为5.92±3.45,腿痛平均VAS为8.92±1.81。第2组25例,平均ODI为68.75±11.81,背痛平均VAS为8±1.22,腿痛平均VAS为7.87±1.57。两年时,第1组平均ODI改善至22.64±17.2(P<0.0001),背痛平均VAS降至2.04±1.86(P = 0.0002),腿痛VAS降至1.56±1.97(P<0.0001)。第2组平均ODI为24±10.6(P<0.0001),背痛平均VAS为2.12±1.43(P = 0.0009),腿痛平均VAS为2.56±1.35(P = 0.0008)。两组在功能改善方面具有统计学可比性。

结论

显微腰椎减压术在两组中产生了可比的功能结局。该手术为保留退行性低度(迈耶丁1级)腰椎滑脱症腰椎运动节段的完整性提供了可行选择。

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Symptomatic lumbar stenosis due to low-grade degenerative spondylolisthesis can effectively be treated with mere decompression.
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