Lombardi J S, Wiltse L L, Reynolds J, Widell E H, Spencer C
Spine (Phila Pa 1976). 1985 Nov;10(9):821-7. doi: 10.1097/00007632-198511000-00008.
The purpose of this article is to evaluate three surgical approaches to the treatment of degenerative spondylolisthesis. A review of 107 surgically treated cases were used to select a group of patients who met the following criteria: No previous spine surgery, no involvement in litigation, and no significant lesions at other levels of the spine. Adequate follow-up. The selected group of 47 surgically treated cases of degenerative spondylolisthesis had follow-up of 2-7 years. Three surgical approaches to the treatment of degenerative spondylolisthesis were analyzed. A relatively small patient group with a wide posterior decompression, at the level of the slip, sacrificing the articular processes had good to excellent results in only 33% of the cases. A second group with a midline posterior decompression with preservation of the articular processes had 80% good to excellent results after 2 years. The third group with a midline decompression and preservation of the articular processes had an added intertransverse process fusion between the olisthetic levels. This group had 90% good to excellent results. The conclusion is that a posterior decompression with preservation of the articular processes plus a transverse process fusion at the involved level is the preferred method of treatment for degenerative spondylolisthesis without regard to age.
本文的目的是评估三种治疗退行性腰椎滑脱症的手术方法。回顾107例接受手术治疗的病例，从中选取一组符合以下标准的患者：既往无脊柱手术史、未涉及诉讼、脊柱其他节段无明显病变。随访充分。所选的47例接受手术治疗的退行性腰椎滑脱症患者的随访时间为2至7年。分析了三种治疗退行性腰椎滑脱症的手术方法。一组相对较小的患者，在滑脱节段进行广泛的后路减压，牺牲关节突，只有33%的病例取得了良好至优秀的效果。第二组进行中线后路减压并保留关节突，2年后80%的病例取得了良好至优秀的效果。第三组进行中线减压并保留关节突，在滑脱节段之间增加了横突间融合。该组90%的病例取得了良好至优秀的效果。结论是，保留关节突的后路减压加上受累节段的横突融合是治疗退行性腰椎滑脱症的首选方法，与年龄无关。
