| Objective:Evaluation of PLIF surgery (posterior approach vertebral pedicle screw system and cage fusion surgery) treatment of degenerative lumbar spondylolisthesis with short-term follow-up radiographic and functional outcome, and the results were statistically analyzed for clinical reference.Methods:Retrospective analysis of the implementation of the study, outpatient or telephone booking form, to February 2012 to December 2013 in affiliated hospital of Chengdu University of traditional Chinese medicine in hospital diagnosed with degenerative spondylolisthesis, reduction and posterior decompression and fusion with internal fixation (posterior approach vertebral pedicle screw system and cage fusion), met the inclusion criteria and complete clinical information and follow-up data follow-up study performed in 30 patients. By hospital Radiology Imaging System saving data access previous lumbar spine radiographs and CT Imaging data, after evaluation of preoperative pathological changes and reduction and fusion. All underwent preoperative and postoperative follow-up of patients with low back pain caused by JOA scoring and the VAS score, according to Greenough standard to assess clinical efficacy and good rate. The collected data using SPSS 19.0 software for statistical analysis, test level of a=0.05. Preoperative and postoperative data using independent samples t-test, evaluation of PLIF in the treatment of patients with degenerative spondylolisthesis short term effect. Using univariate filters, and multiple correlation analysis to know age, course, slip, segment and JOA scoring before surgery and other factors that may influence the effect of operation and curative effect of relativity.Results:Last follow-up JOA scoring (25.10 ± 0.92) compared with preoperative (14.23±3.91) significantly improved (t=-29.575, P=0.00<0.01), the improvement rate (80.10±6.61)%. Last follow-up VAS score (0.53±0.51) compared with preoperative (6.43±0.94) has significantly improved (t=30.37, P=0.001<0.01). Clinical efficacy under the Greenough standards:excellent in 15 patients, good in 13 cases, just so so 2 cases, excellent rate of 93.33%. According to Lenke convergence criterion,28 cases of lumbar spinal fusion reached A grade,93.33%. B grade 2 cases, 6.67%. Univariate analysis showed the correlation between the course of disease, low back pain before surgery JOA score and of last JOA improvement rate have statistical significance (P<0.05), using the multiple correlation analysis to analyse the correlation between the course of disease, low back pain before surgery JOA score and of last JOA improvement rate, Preoperative JOA scoring as a fixed variable, late times JOA improved rate and course of partial related coefficient=-0.637,P=0.001, considered the last times JOA improved rate and course negative related has statistics meaning, Description that course of disease is a risk factor for clinical, the longer of the course the worse of the effect. Change the fixed variables to course, the partial correlation coefficient of last JOA improvement rate and preoperative JOA score =0.531,P=0.023, considered that there was a significant linear correlation between the preoperative JOA scores and JOA improved rates, JOA scoring is protective factors, higher the score, the curative effect is better.Conclusion:Clinical results of this study and previous literature suggests that posterior decompression and reduction and fusion with internal fixation in the treatment of degenerative spondylolisthesis with standard surgery. Outright nerve decompression, effective decollement reset, good strong spinal fusion and internal fixation combined with specific measures of the individual can be satisfactory clinical results. Application of posterior decompression and reduction and fusion with internal fixation (posterior approach vertebral pedicle screw system and cage fusion surgery) treatment of degenerative spondylolisthesis can provide primary stability of the spine, improve symptoms, functional status, normalise physiological imaging performance, is an effective clinical treatments, and the segment recovery of upper and lower mechanical structure makes sense. DLS fusion short-term postoperative curative effect is influenced by many factors, preoperative JOA score and duration of illness and the effect of shows is a correlation. Individually, satisfactory clinical effects are the result of physicians and patients to work together. Patients should seek medical advice as soon as possible, physicians should be clear indications, seize the best opportunity to develop reasonable operational scheme. |
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