Surgical Treatment Of Double - Segment Lumbar Spondylolisthesis

Objective: To investigate the clinical efficacy of posterior lumbar interbody fusion with pedicle screws in treatment of double-segment lumbar spondylolisthesis.Methods: Twenty patients(from January, 2009 to January, 2013) with double-segment lumbar spondylolisthesis who were treated with posterior lumbar interbody fusion with pedicle screws, including posterior lumbar-spinal canal decompression, nerve root release,interbody graft fusion, pedicle screws reduction and fixation, were reviewed. Clinical functional recovery was assessed by Oswestry disability index and visual analog scale.Radiographic data including lumbar slippery percentage, lumbar slippery angle, lumbar height, pelvic tilt angle and sacral slope angle were measured. All data was collected 1day before surgery, 1 day, 3 months, 6 months and 1 year after surgery, and every year constantly.Results: All 20 patients were followed up for 6 months to 3 years. Oswestry disability index and visual analog scale were lower after surgery and at the final follow-up, when compared with before surgery(P<0.05). Lumbar disc height was significantly increased after surgery and at the final follow-up, than those of pre-operation(P<0.05). Lumbar slippery percentage, pelvic tilt angle and sacral slope angle were improved significantly after surgery and at the final follow-up, when compared with before surgery(P<0.05).During the follow-up, there were no signs of rupture, loosing or falling in the internal fixation and no pseudarthrosis.Conclusion: Reposition and reliable fusion of the bone graft were achieved satisfactorily in all patients. All patients are satisfactory of posterior operation with pedicle screw internal fixation, reduction, decompression in treating double-segment lumbar spondylolisthesis, due to satisfactory reduction, reliable fixation, high fusion rate and reconstruction of normal sagittal sequence in lumbar spine, which can enhance the stability of lumbar spine.