Clinical Observation Of Adjacent Vertebral Segmental Degeneration After Operation For Degenerative Spondylolisthesis

Objective To investigate the degeneration of adjacent segments of lumbar spondylolisthesis after different degrees of reduction of the pondylolisthesis.Methods Fifteen patients with L4 degenerative spondylolisthesis diagnosed in our hospital from January 2015 to January 2017 were collected,including 3 males and 12 females.According to Meyerding grading,there were 5 cases of I degree spondylolisthesis and 10 cases of II degree spondylolisthesis.The age was 54.33(+10.98).The average follow-up time was 23.3(+3.5 months).All patients received surgical treatment by the same surgeon with complete imaging data,including preoperative and last follow-up L3-S1 spiral CT examination and positive and lateral lumbar spine radiography.The hospital image archival and communication system was used to measure the following parameters: preoperative and last follow-up L3-L4 relative vertebral space height,L5-S1 relative vertebral space height,L3-L4 lumbar facet joint degeneration,L5-S1 lumbar facet joint degeneration,and preoperative,postoperative and last follow-up VAS score.According to the degree of reduction of lumbar spondylolisthesis after operation,the patients were divided into two groups: complete reduction group and incomplete reduction group.The degree of degeneration of adjacent segments,namely L3-4 and L5-S1 facet joints,the change of intervertebral space height and VAS score of patients before,after and at the last follow-up,were observed.The degeneration of adjacent segments between the two groups was compared.Results(1)In the incomplete reduction group,the degeneration degree of adjacent segment facet joints is higher,but the degeneration of adjacent segment facet joints is more likely to occur in the head segment in either the complete reduction group or the incomplete reduction group.(2)There is no difference between the two groups in the relative height of the adjacent segment of the operative segment between the complete reduction group and the incomplete reduction group.(3)The degree of pain relief in patients with spondylolisthesis is related to the degree of reduction during operation.In the last follow-up,the better the degree of reduction,the more obvious the pain relief in patients with spondylolisthesis.Conclusion(1)The reduction of the spondylolisthesis vertebral body in different degrees in patients with degenerative lumbar spondylolisthesis is related to the degree of adjacent facet joint degeneration and pain relief after operation,the better the reduction degree of spondylolisthesis,the lighter the degeneration degree of articular facet joints of adjacent segments,and the better the long-term pain relief effect after operation.(2)During the operation,the spondylolisthesis should be reduced as much as possible.