Aparício Rafael Augusto da Silva, Pinto Felipe de Almeida, Alves Rafael Félix, Ribeiro Victor Hugo Cordeiro
Hospital Geral de Carapicuiba, Sao Paulo, SP, Brazil.
Santa Casa de Misericordia de Ribeirao Preto, Ribeirao Preto, Sao Paulo, SP, Brazil.
Acta Ortop Bras. 2025 Aug 18;33(3):e287254. doi: 10.1590/1413-785220253303e287254. eCollection 2025.
In persistent and debilitating cases of spondylolisthesis, surgical correction is usually indicated, and the surgeon may opt for spinal fusion or dynamic stabilization techniques, such as lumbar facet arthroplasty (LFA). However, LFA is an emerging technique that requires more research to fully understand its effectiveness and safety. To summarize the scientific evidence related to LFA in the surgical correction of spondylolisthesis. The database chosen to papers selection was PUBMED, based on the following search string: ((lumbar[title/abstract] AND facet[title/abstract] AND arthroplasty[title/abstract]) OR tops[title /abstract]) AND spondylolisthesis[title/abstract], including studies published in the last 10 years. Results: Initially, 9 papers were identified that met the previously established search strategy. After reading the titles and abstracts, 1 text was excluded because it did not deal with the application of LFA in spondylolisthesis, leaving 8 studies for review. Significant clinical improvement, maintenance of radiological stability and low complication rates were consistently observed with the use of LFA. Furthermore, economic analyzes indicated that the TOPS System is a cost-effective and economically dominant option compared to conventional approaches such as TLIF. These findings suggest that the TOPS system may be a viable and advantageous alternative for patients with degenerative spondylolisthesis, offering not only clinical but also long-term economic benefits. .
在腰椎滑脱的持续性和衰弱性病例中,通常需要进行手术矫正,外科医生可能会选择脊柱融合术或动态稳定技术,如腰椎小关节置换术(LFA)。然而,LFA是一种新兴技术,需要更多研究来充分了解其有效性和安全性。总结与LFA在腰椎滑脱手术矫正中相关的科学证据。选择PUBMED数据库进行文献筛选,基于以下搜索字符串:((“腰椎”[标题/摘要] AND “小关节”[标题/摘要] AND “置换术”[标题/摘要]) OR “tops”[标题 /摘要]) AND “腰椎滑脱”[标题/摘要],包括过去10年发表的研究。结果:最初,识别出9篇符合先前既定搜索策略的论文。阅读标题和摘要后,排除1篇文献,因为它未涉及LFA在腰椎滑脱中的应用,剩下8项研究进行综述。使用LFA时始终观察到显著的临床改善、放射学稳定性的维持和低并发症发生率。此外,经济分析表明,与传统方法如经椎间孔腰椎椎体间融合术(TLIF)相比,TOPS系统是一种具有成本效益且在经济上占主导地位的选择。这些发现表明,TOPS系统对于退行性腰椎滑脱患者可能是一种可行且有利的替代方案,不仅提供临床益处,还带来长期经济效益。