Treatment Of Lumbar Spondylolisthesis With Rigid Isthmus By Intervertebral Distraction Reduction

Objective To explore the treatment experience of lumbar spondylolisthesis with rigid isthmus treated by intervertebral distraction reduction.Methods A total of 64 patients with isthmic spondylolisthesis who were admitted to the Second Affiliated Hospital of Nanchang University from October2018 to September 2020 were collected.In group A,34 patients were treated with intervertebral distraction combined with universal screw surgery,and 30 patients in group B were treated with traditional surgical methods.Long-tail fixation screws were used in all patients to open the intervertebral space at the end of the screws.Both groups underwent posterior total laminectomy and internal fixation by the same operator.The clinical efficacy of the two distraction methods was evaluated by collecting and analyzing intraoperative related indexes,preoperative and postoperative imaging parameters,and VAS and JOA scores.Results There was no significant difference in the three intraoperative indexes(P>0.05).The average sliding distance of vertebral bodies in both groups after operation was significantly shorter than that before operation.At the same time,the reduction effect of intervertebral distraction combined with universal screw in group A was better than that in group B,and the difference was statistically significant(P<0.05).The area of intervertebral foramen and the height of intervertebral space in both groups after operation were significantly increased compared with those before operation.At the same time,the area of intervertebral foramen and the height of intervertebral space in group A increased significantly compared with group B after operation,and the difference was statistically significant(P<0.05)..The average fusion degree of group A was better than that of group B.The postoperative JOA and VAS clinical efficacy scores in both groups were significantly improved compared with those before surgery,and there was no significant difference between the groups within 1 month after surgery(P>0.05).Compared with group B,the improvement was obvious,and the difference was statistically significant(P<0.05).Complications: 4 cases in group A and 6 cases in group B.Conclusion Compared with traditional surgical reduction,intervertebral distraction reduction has better long-term clinical effect and less complications in the treatment of stiff isthmic spondylolisthesis.