Clinical Efficacy Of Pedicle Screw With PLIF For The Treatment Of Middle-aged Lumbar Spondylolisthesis

Objective To evaluate the clinical efficacy of pedicle screw fixation, laminectomy decompression with PLIF for the treatment of middle-aged lumbar spondylolisthesis and to study the advantages and disadvantages of various surgical approach for lumbar spondylolisthesis.Method We collect26middle-aged patients with lumbar spondylolisthesis who undergone surgical treatment in our hospital from2011-5to2012-12, including9males and17famales with a mean age of56.3years at baseline and an age range from47to68years; the patients with the disease for6months to8years, The average course of the disease is5year; diagnoses included15cases of spondylolisthesis at L4,11cases of spondylolisthesis at L5,12cases of grade I spondylolisthesis,14cases of grade â…¡ spondylolisthesis. All the cases received the surgery of PLIF with pedicle screw, and in-time treatment was provided. To evaluate the efficacy, including short-term postoperative complications, fusion, dics height, lumbar lordosis and clinical efficacy evaluation(JOA score and the improvement rate), and so on.Results26patients were followed up for3-14months with an average of6.5, no patient had short-term (3to14months) serious postoperative complications, only a small number of patients had complications such as mild leakage of cerebrospinal fluid and a transient low back pain, they were all alleviated after symptomatic treatment; the fusion rate reaches Lenke standard A-level in14cases, accounting for53.8%.B-level in8cases, accounting for30.8%.C-level in4cases, accounting for15.4%; At the time of the postoperative and lastest follow-up, dies height and lumbar lordosis improved significantly compared with the preoperative, and the difference was statistically significant (P<0.05), the data of dies height and lumbar lordosis both decreased during the lastest follow-up and postoperation, there was no statistical difference between them(P>0.05); the life quality has significantly improved after three months of the surgery, and JOA score compared with the preoperative was significantly increased, the difference was statistically significant (P<0.05), the improvement rate of JOA Score:12excellent,12good and2medium.Conclusion pedicle screw fixation, laminectomy decompression with PLIF could significantly improve the quality of life of middle-aged patients with mild-to-moderate lumbar spondylolisthesis, and could effectively correct the loss of spondylolisthesis, reconstruct the stability of spinal and improve the fusion rate, so it is a safe and effective surgical approach.