Evaluation Of 52 Cases Of Isthmic Spondylolisthesis By Posterior Decompression And Interbody Fusion And Pedicle Screw Fixation Method

【Objective】:We analyze the effect of the treatment in isthmic spondylolisthesis by posterior decompression and interbody fusion and pedicle screw fixation method. Evaluation focused on: comparison JOA scores of low back pain and leg pain; interbody fusion; slip conditions and complications before and after surgery.【Method】:All patients were treated with posterior decompression, pulling and fixing the slip as much as possible with pedicle screw-rod system; removing the damaged disc tissue; retaining the integrity of the anterior longitudinal ligament and fusing interbody with particles of autogenous bone and (or) allogeneic bone fully. All patients were isthmic spondylolisthesis. There are 6 cases in gradeⅠ, gradeⅡof 40 cases,Ⅲdegree in 5 cases,gradeⅣof 1 case and 15 cases of spondylolisthesis L4, L5 spondylolisthesis in 34 cases, L4 and L5 spondylolisthesis in 3 cases. Between the ages of 10-66 years, the mean was 45.8 years, all patients were followed up in 6 months to 5 years, the average is 18 months.【Result】:27 cases, symptoms disappeared after surgery (JOA score was excellent), 14 cases significantly improved (JOA score was good), and 11 cases remaining some symptoms was relieved (JOA score was fair). After 6 months of follow-up, symptoms disappeared in 32 cases,15 cases significantly improved, and the remaining 5 patients had some symptoms but left some degrees of lumbar and leg pain and lower extremity sensory abnormal. X-ray film showed complete reduction of slip of 38 cases, and the remaining 14 cases are part of the reduction. There are no complications such as cerebrospinal fluid leakage and deterioration at postoperative, Before 4 years,one patience has underwent PLIF surgery as L4 spondylolisthesis, three years later due to DDD of L5 lumbar and leg pain symptom, was treated well with the other surgery. All patients were interbody fusion after operation 6-12 months without implant loosening, loss intervertebral height and reduction conditions. According to JOA score standard, after surgery in all cases the excellent was 78.8%, at 6 month follow-up rate was 90.3%.【Conclusion】:Treating isthmic spondylolisthesis with posterior decompression, moderate reduction, as short as segment pedicle screw system fixation and lumbar interbody fusion can abtain the satisfacted recent results as the long-term results.