The Efficacy Of Early Ambulation After Lumbar Interbody Fusion And Internal Fixation Of Spondylolisthesis

Objective:To explore the time to safe ambulation after lumbar spondylolisthesis surgery in order to provide theoretical and practical foundation for application of early rehabilitation in clinical.Methods:A total of 75 patients from Aug 2013 to Apr 2014 with lumbar spondylolisthesis underwent the posterior interbody fusion and internal. According to the order of admission to hospital, the patients were divided into three groups with 30 cases in each group. According to the order of admission to hospital, the patients were divided into three groups with 25 cases in each group. Group A began to ambulate on postoperative day 3; Group B began to ambulate on the 3 weeks after operation; Group C began to ambulate on the 6 weeks after operation. The clinical functional outcomes were evaluated according to Oswestry disability questionnaire(ODI), Visual Analogue Scale(VAS), the interbody fusion rate, the rate of pedicle screw loosening or breakagean, the incidence of short-term complication.Results:The difference of the VAS, ODI scores in three groups was not statistically significant (all P> 0.05) before surgery. After surgery, the VAS and ODI scores were less than those of before surgery in each group and the difference was statistically significant (all P<0.05). After surgery the pairwise comparisons of VAS, ODI scores are different from each other, and the differences were statistically significant (all P<0.05), and lower scores in group A are most obvious. The pairwise differences of improvement rate of lumbar function after surgery were statistically significant (all P<0.05), and the improvement rate in group A is the best. At 6 month after operation, the interbody fusion rate was 58.33% (14/24) in group A,52.17%(12/23) in group B and 54.17%(13/24) in group C, showing not statistically significant (χ2=0.189,P>0.05); at last follow-up, the fusion rate was 79.16%(19/24) in group A,73.91%(17/23) in group B, 70.83%(17/24) in group C, showing not statistically significant(x2=0.450,P>0.05). Three groups of patients after the postoperative were not appear Internal fixation to loose or break. The pairwise differences of short-term complications after surgery were statistically significant(P<0.05), and the occurrence rate in experimental group is the lowest.Conclusion:For patients with lumbar spondylolisthesis who began to ambulate with waist support 3 days after receive the posterior interbody fusion and internal can improve the VAS, ODI scores, advance the improvement rate, reduce the incidence of short-term complication.