Surgical treatment of adult isthmic spondylolisthesis

ZHANG Si-meng; LI Zhong-hai; SUN Tian-sheng

doi:10.3969/j.issn.2095-252X.2014.01.002

Abstract：Objective To retrospectively explore the clinical outcomes of intervertebral space distraction reduction and posterior lumbar interbody fusion with transpedicular screw/rod ifxation in the treatment of adult isthmic spondylolisthesis.Methods From October 2006 to November 2011, 78 patients with adult isthmic spondylolisthesis underwent the treatment of intervertebral space distraction reduction and posterior lumbar interbody fusion with transpedicular screw/rod ifxation, and their clinical data were retrospectively analyzed. There were 42 males and 36 females, whose average age was 52.4 years old ( range; 41-69 years ). The average course time was 38 months ( range;3-84 months ). The levels of lumbar spondylolisthesis was L3 in 3 cases, L4 in 28 cases and L5 in 47 cases. According to the Meyerding classiifcation, 25 cases were classiifed as degree I, 47 cases as degree II, and 6 cases as degree III. The average slippage degree was ( 39.3±10.9 ) %. The Visual Analogue Scale ( VAS ) and Oswestry Disability Index ( ODI ) were used to assess the clinical outcomes, and the imaging examination was also performed.Results The average surgical time was 118 minutes, and the average intraoperative blood loss was 340ml. All patients were followed up for an average period of 41 months ( range; 24-83 months ). The VAS scores were 6.7±1.5 points and 1.7±1.3 points preoperatively and in the latest follow-up respectively, and the differences were statistically signiifcant (P<0.05 ). The ODI scores were ( 60.7±9.8 ) % and ( 24.1±4.9 ) % preoperatively and in the latest follow-up respectively, and the differences were statistically signiifcant (P<0.05 ). The slippage degree was ( 9.8±4.1 ) % in the latest follow-up, with the reduction rate of 75.1% and the fusion rate of 97.4% at the 2nd year after the operation.Conclusions Intervertebral space distraction reduction and posterior lumbar interbody fusion with transpedicular screw/rod ifxation are safe in the treatment of adult isthmic spondylolisthesis, with the advantages of excellent clinical results, easy manipulation and fewer complications.