Ishikawa S, Kumar S J, Torres B C
Alfred I. duPont Institute, Wilmington, Delaware.
Spine (Phila Pa 1976). 1994 Aug 1;19(15):1691-6. doi: 10.1097/00007632-199408000-00007.
Fourteen patients who had symptomatic dysplastic spondylolisthesis with an intact pars interarticularis underwent posterolateral spinal fusion. Patients initially had low back pain, tight hamstrings, and limited forward bending. In addition, four patients had signs of progressive cauda equina or nerve root impingement. In 10 patients (71%), preoperative degree of slippage was more than 50% (mean, 72%).
Ten patients underwent in situ posterolateral spinal fusion, and four patients with progressive neurologic symptoms had posterior decompression followed by in situ posterolateral spinal fusion.
All patients had solid fusion at last follow-up. A pseudoarthrosis developed in one patient, which healed after a second operation. Roentgenographic progression of the slip after fusion was rare.
This study demonstrated that for dysplastic spondylolisthesis in children and adolescents, in situ posterolateral spine fusion yields satisfactory results. In addition, in the presence of progressive cauda equina or nerve root impingement, posterior decompression may be necessary.
14例有症状的发育异常性腰椎滑脱且关节突完整的患者接受了后外侧脊柱融合术。患者最初有下腰痛、腘绳肌紧张和前屈受限。此外，4例患者有马尾神经或神经根进行性受压的体征。10例患者（71%）术前滑脱程度超过50%（平均72%）。
10例患者接受原位后外侧脊柱融合术，4例有进行性神经症状的患者先行后路减压，然后行原位后外侧脊柱融合术。
所有患者在最后一次随访时均获得了牢固融合。1例患者出现假关节，二次手术后愈合。融合后滑脱的影像学进展罕见。
本研究表明，对于儿童和青少年发育异常性腰椎滑脱，原位后外侧脊柱融合术可取得满意效果。此外，在存在马尾神经或神经根进行性受压时，可能需要进行后路减压。
