An Analysis Of Correlation Factors Effecting The Clinical Outcome Of Surgical Treatment For Lumbar Spondylolisthesis

Objective:To analyze the correlation factors effecting the clinical outcome of surgical treatment for lumbar spondylolisthesis.Methods: From March 2002 to September 2006 , 81 in patients of lumbar spondylolisthesis were collected.All patients took a post midlateral incision,fixed with pedicle screw system, fused by the way of posterolateral or circumferential.A statistical model was build to combine the clinical outcome with ten postulated correlation factors((including patient's age, sex, history of the disease, type of olisthe,slippage degree and segment, anatomy reduction or not, method of bone graft , postoperative activity and fusion outcome).The association between these factors and the optimal outcome was explored by the means of Binary Logistic Regression.Result:The patients were followed up from 6 months to 5 years(average 2.5 years).66 patients with anatomic reduction, the reduction rate is 81.5%; intervertebral height decreased postoperation happened in 14 cases, accounting for 17.3 percent;postoperative slip occured in 10 cases, 12.3 percent of the total..The excellence result were achieved in 49 cases,good in 19 cases, fair in 9 cases,poor in 4 cases.The total excellence rate is 84%.The result of Binary Logistic Regression analysis:Operation methods has no statistics significant influence the postoperative effect of surgical treatment of lumbar spondylolisthesis(P>0.10),such as reduction or not, method of bone graft,neither do the patient's sex, history of disease, type of olisthe, slippage degree and segment have an significant influence the clinical outcome (P>0.10). Such factors as the patient's age, postoperative activity and fusion outcome are statistically significant to the clinical result (P<0.05). Conclusion:Excellent clinical outcome can be achievced with complete decompression, segment fusion with bone graft and internal fixation.Anatomic reduction or not and the method of bone graft do not influence the clinical outcome,the key factors influencing the clinical outcome,neither do the patient's sex, history of disease, type or grade of olisthe.Postoperative recovery activity and the fusion outcome are closely connected with the clinical outcome.Patient's age is one key factor influencing the clinical outcome.In fact,we believe that old persons who tend to recover less fast, incorrect postoperative activity may result in intervertebral height decrease and postoperative slip, therefore influence the clinical outcome in the end.