|
Objective To investigate the posterior vertebral spinous process of autologous interbody fusion for lumbar spondylolisthesis surgical results and clinical feasibility. Methods Taian Central Hospital orthopedic September 2007 - August 2009 made between the posterior lumbar interbody fusion and pedicle screw fixation for the treatment of spondylolisthesis patients, 73 patients with complete data on 56 cases in which patients a retrospective analysis, including 21 males and 35 females, aged 36-69 years (mean 55.6 ± 9.1 years), duration of 8 months to 20 years, an average of 4 years and 6 months. All patients underwent preoperative presence of significant low back pain or sciatica, and by the standard conservative treatment is ineffective. X-ray, CT and MRI or discography and other tests are found to have significant lumbar intervertebral joints degeneration. All cases were divided into three groups: autologous vertebral interbody spine patients (A group) 26 cases (32 segments), including 9 males and 17 females; application Cage interbody fusion patients (B group) 12 cases (14 segments), including 5 males and 7 females; autogenous iliac bone graft group (C group) 18 cases (22 segments), including 7 males and 11 females. Three groups of patients in terms of gender, age, duration, and magnitude of slip out of line segment were not significantly different. Surgery for the same group of people at different times of surgery, postoperative lumbar regularly positive side and the flexion and extension dynamic lateral X-ray film and CT were measured in three groups of patients before surgery, surgery and follow-up terminal segment of the vertebral clearance height, lumbar lordosis angle and bony fusion rate; while the patient length of stay, operative time, blood loss, total medical costs, interbody fusion single segment increased medical costs, the clinical efficacy of intraoperative and postoperative complications Comparison. The observed indicators for statistical analysis to compare the difference if there is significant. SPSS16.0 software processing application data. The results of the three groups of patients operative time, blood loss, hospital costs, interbody fusion single segment increased medical costs and surgical complication rates are significantly different: autologous vertebral spinous process interbody group and the group Cage operative time than autogenous iliac bone graft group should be short, the amount of bleeding and fewer; postoperative morbidity Cage group (33.3%) than in the other two groups (15.4%, 16.7%) is higher, hospital costs, interbody fusion single segment increased health costs are also much higher than the other two groups; hospitalization time, but the three groups showed no significant difference. Imaging technique first three patients were intervertebral height index (%) were 23 ± 4,23 ± 3 and 23 ± 4, respectively, after 32 ± 4,32 ± 3 and 31 ± 4; surgery three groups of cases lumbar lordosis angle (°) were 33.0 ± 8.1,33.7 ± 10.1 and 34.4 ± 7.3, respectively, after 37.2 ± 7.8,40.7 ± 8.9 and 37.9 ± 6.9; three groups of cases intervertebral height, lumbar lordosis compared with preoperative significant recovery was statistically significant (P lt; 0.05); among the three groups before surgery and one year after the final follow-up disc space height and lumbar lordosis showed no significant difference . Three groups of patients after 12 months compared fusion rate (93.8%, 92.9%, 100%) had no significant difference (P gt; 0.05). JOA score improvement rate comparison, excellent rate among the three groups (92.3%, 83.3%, 88.9%) had no significant difference (P gt; 0.05), postoperative patient's clinical symptoms disappeared, all three surgical methods have made obvious outcome. Conclusions are three kinds of surgical treatment of spondylolisthesis effective procedure, and have achieved good clinical efficacy. However, autologous posterior vertebral spinous process interbody fusion is simple, less invasive, fusion rate, can make full use of autologous bone decompression obtained, reduce treatment costs, fewer complications, need to be applied to all Spinal decompression laminectomy incision interbody fusion spondylolisthesis, is a strong and broad indications of clinical feasibility of effective and reliable treatment of lumbar spondylolisthesis.
|