The Clinical Efficacy Of PLIF In Treatment Of Degenerative Lumbar Spondylolisthesis

Object:To observe the treatment efficacy of degenerative lumbar spondylolisthesis with the method of Posterior Lumbar Interbody Fusion(PLIF) associated decompression and internal fixation by pedicle screw system.Methods:35 patients with lumbar vertebrae degenerative spondylolisthesis with spinal stenosis were treated by PLIF associated decompression and internal fixation by pedicle screw system during February 2013 to October 2014 in the Orthopedic Surgery of the Second Affiliated Hospital of Suzhou University(average age 55.78±10.12 years, including 8 males and 27 females, 28 examples of grade I spondylolisthesis and II degree spondylolisthesis 7 cases,). The patients were all followed up.Follow-up period was a month, 6 months, 12 months after operation(average was 8.66 ± 1.64 months), the patients before surgery, after one month, 6 months, 12 months and JOA score and Oswestry Disability Index(ODI) were used to assess pain relief and functional improvement.And assess the lumbar fusion rate, the rate of spondylolisthesis, relative intervertebral height and segmental lordosis(SL)by X-ray examination, all the data were analyzed using SPSS17.0.Results:All patients were successfully operated, average operative time was 129.2±26.6min; average amount of bleeding was 469.6±106.3ml, dural rupture occurred in 1 case, 3 cases involved nerve root pain, after symptomatic treatment all cured. The JOA score of, a month after surgery, six months, 12 months was respectively 23.33 ±2.06, 24.19±2.34, 25.14±2.33, that was significantly increasd compared with preoperative which was 15.24±2.97, differences were statistically significant(P<0.01). Good rate was 91.4% which involved excellent in 17 cases, good in 15 cases, general effect in 3 cases, no poor result cases. The ODI score was respectively15.36±5.36, 10.12±5.18, 10.06±5.31,were significantly lower than preoperative which was 43.05±7.26, differences were all statistically significant(P<0.01), the relative intervertebral height of one month 12.2 ± 2.2mm after surgery compared with preoperated which was 10.6±2.3mm achieved significant improvement(P<0.05),little change occurred compared with 6 months and 12 months after operation(P>0.05), Slippage rate of one month after surgery 0.11 ± 0.03 compared with preoperatively 0.36 ± 0.05, the difference was statistically significant(P<0.05), During the follow-up period there were no internal fixation loosening, fracture, nither fusion shift nor failed, no adjacent segment degeneration(ASD) and other complications.Conclusion:Posterior spinal decompression and interbody fusion associated with pedicle screw fixation is effective in treatment of lumbar vertebrae degenerative spondylolisthesis with spinal stenosis.