Clinical Study On Treating Degenerative Lumbar Spondylolisthesis With Pedicle Screw Fixation And Interbody Fusion

Objective: To evaluate the short-term follow-up imaging and functional results of degenerative lumbar spondylolisthesis with treatment of pedicle screw fixation and interbody fusion,and the results were analyzed for clinical reference.Methods: By telephone or out-patient appointments and other forms,22 patients underwent operations from February 2008 to March 2011 for surgical treatment of degenerative lumbar spondylolisthesis in Affiliated Hospital of Shandong University of TCM orthopedics spine department. 22 cases,who met the inclusion criteria,had full clinical and follow-up data,were followed up. We use JOA Low Back Pain score and JOA scroe improved rate to assess the preoperative and final follow-up informations.We use independent samples t test for age, disease course,lesion segment, lumbar instability, facet joint tropism and symmetry with the JOA score improved rate for statistical analysis.We use paired t test to analyse the preoperative and final follow-up of the involved segment of the vertebral slip rate,the lower disc height ratio and the upper disc height ratio statistically.We use Spearman to analyse the relevance of JOA score improved rate and spine fusion.Results: JOA preoperative score was 12.95 points(8～18 points), the Last follow-up average score is 24.91 points(22～27 points);the average JOA score improved rate is 75.06%;JOA score improved rate assessment: excellent in 13 cases, good in 9 cases;excellent and good rate was 100%.Preoperative VAS pain index average score is 8.27(7～10),the last follow-up is 2.18(0～4);comparing the preoperative and postoperative pain index,the degree of pain improved significantly.In accordance with the Lenke lumbar fusion index:A grade is 12 cases,accounting for 54.55%;B grade is 8 cases,accounting for 36.36%,C grade is 2 cases,accounting for 9.09%,the excellent rate is 90.91%.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 is less than 0.05.Short-term follow-up of vertebral slip are properly corrected and maintained a goodreduction;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.Conclusion: To treat degenerative lumbar spondylolisthesis with pedicle screw fixation and interbody fusion can provide immediate stability and significant improvement symptoms,functional status and the imaging expressions tends to normal physiological form.It is an effective Clinical treatment and meaningful to the recovery of mechanical structure of upper and lower segmental lesions; interbody fusion do no correlate with clinical efficacy; course,segmental stability and facet joint tropism and symmetry are meaningful to the evaluation of last follow-up. To accurate analyze them will help improve the efficacy of surgery .