Treatment Of Pedicle Screw Fixation And Interbody Fusion For Adult Isthmic Spondylolisthesis: Analysis Of Short-term Efficacy And Its Influencing Factors.

Objective:To evaluate the short-term follow-up imaging and functional results of adult isthmic spondylolisthesis with treatment of pedicle screw fixation and interbody fusion, the results were analyzed for clinical reference.Methods:By telephone or out-patient appointments and other forms,21 patients underwent operations from June 2005 to February 2009 for surgical treatment of isthmic spondylolisthesis in Affiliated Hospital of Shandong University of TCM orthopedics spine department.21 cases,who met the inclusion criteria,had full clinical and follow-up data,were followed up. JOA Low Back Pain score and JOA scroe improved rate were used to assess the preoperative and final follow-up informations. Independent samples t test was used for age, disease course, lesion segment,trauma,lumbar instability, facet joint tropism and symmetry with the JOA score improved rate for statistical analysis. Paired t test was uesd to analyse the preoperative and final follow-up of the involved segment of the vertebral slip rate,the disc height ratio and the upper disc height ratio statistically. Spearman test was used to analyse the relevance of JOA score improved rate and spine fusion.Conclusion:JOA preoperative score was 13.33 points (9～21 points), the Last follow-up average score is 24.81 points (23-27 points);the average JOA score improved rate is 72.90%; JOA score improved rate assessment:excellent in 9 cases, good in 12 cases. Preoperative VAS pain index average score is 6.81 (0-8),the last follow-up is 1.62 (0-3); comparing the preoperative and postoperative pain index, the degree of pain improved significantly.In accordance with the Lenke lumbar fusion index:12 cases are A grade,accounting for 57.14%; 5 cases are B grade, accounting for 23.81%. The disease course,lumbar instability, facet joint surface tending to sagittal, as well as the asymmetry of facet joints are influential to the efficiency of the final follow-up surgery, P< 0.05.Short-term follow-up of vertebral slip are properly corrected and maintained a good reduction; lesion segment of intervertebral height is corrected, as well as the upper disc height. And there is no finding of adjacent segment disc degeneration.There is no correlation between JOA score improved rate and spine fusion.