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首页> 外文期刊>Journal of orthopaedics and traumatology: official journal of the Italian Society of Orthopaedics and Traumatology >Surgical treatment of symptomatic degenerative lumbar spondylolisthesis by decompression and instrumented fusion
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Surgical treatment of symptomatic degenerative lumbar spondylolisthesis by decompression and instrumented fusion

机译：减压联合器械融合治疗症状性退行性腰椎滑脱症

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摘要

Abstract Degenerative spondylolis-thesis is characterized by the slippage of one vertebral body over the one below, with association of intervertebral disc degeneration and degenerative arthritis of the facet joints, which cause spinal stenosis. The aim of this study was to evaluate the clinical and radiographic results of 22 patients with symptomatic degenerative spondylolisthe-sis, operated on by decompressive laminectomy and instrumented pos-terolateral fusion associated with interbody fusion (PLIF). Mean age at surgery was 64 years (range, 57-72). Clinical results were evaluated on a questionnaire at the last follow-up visit concerning postoperative low back and leg pain, restriction of daily life activities, and resumption of sports activity. Lumbar spine radiographs were used to evaluate the status of fixation devices, the reduction of the spondylolisthesis, the lumbar sagittal balance and the presence of spinal fusion. No intraoperative or postoperative complications were encountered. There were no superficial or deep infections, fixation device loosening, or hardware removal. Mean follow-up time was 4 years (range, 3-6 years). Clinical outcome was excellent or good in 19 patients and fair in 3 patients. Preoperatively, mean forward vertebral slipping on neutral lateral radiographs was 5 mm, while postoper-atively it decreased to 3 mm. Preoperatively, mean sagittal motion was 3 mm and angular motion was 8?, while postopera-tively these values decreased to 1 mm and 1?, respectively. This study demonstrated that spinal decompression followed by transpedicular instrumentation associated with PLIF technique is a valid surgical option for the treatment of degenerative spondylolisthesis with symptomatic spinal stenosis. Clinical outcome, intended as relief of pain and resumption of activity, was improved significantly and fusion rate was high.
机译：摘要退行性脊椎假体的特征是一侧椎体滑移至下方，并伴有椎间盘退变和小关节退行性关节炎，从而引起椎管狭窄。这项研究的目的是评估22例有症状的变性退行性滑脱的患者的临床和影像学结果，这些患者通过减压椎板切除术和与椎间融合术（PLIF）进行的器械后外侧融合治疗。手术的平均年龄为64岁（范围57-72）。在最后一次随访中，通过问卷调查评估了临床结果，涉及术后腰背和腿部疼痛，日常生活活动受限以及运动恢复。腰椎X线照片用于评估固定装置的状态，脊椎滑脱的减少，腰椎矢状位平衡和脊柱融合的存在。没有遇到术中或术后并发症。没有浅表或深层感染，固定装置松动或硬件拆除。平均随访时间为4年（范围3-6年）。 19例患者的临床结局为优秀或良好，3例患者的临床结果为中等。术前在中性侧位片上平均向前椎体滑移为5 mm，而术后平均滑移降至3 mm。术前平均矢状运动为3mm，角运动为8°，而术后这些值分别降至1mm和1°。这项研究表明，脊柱减压再加上带PLIF技术的经椎弓根器械治疗是治疗有症状性脊椎狭窄的退行性脊柱滑脱的有效手术选择。旨在缓解疼痛和恢复活动的临床结局得到了显着改善，融合率很高。

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