Clinical Effect Of Single And Double Interbody Fusion Cage Combined With Pedicle Screw In The Treatment Of Degenerative Lumbar Spondylolisthesis

Objective:To study the clinical effects of single and double cage combined with pedicle screw fixation in the treatment of degenerative lumbar spondylolisthesis(DLS).Methods:From March 2015 to February 2018,patients with degenerative lumbar spondylolisthesis who underwent posterior approach laminectomy,spinal canal decompression,reduction and interbody fusion(cage)pedicle internal fixation in the same spinal treatment team in the department of orthopaedics of our hospital were collected as research objects for retrospective study.In strict accordance with the perfect criteria for the inclusion and exclusion of experimental cases,65 cases were collected,including 37 cases of single cage patients(group A)and 28 cases of double cage patients(group B).Baseline data were used to compare whether there were differences in gender,age,body mass index(BMI)and surgical segment between the two groups.The operation time,intraoperative blood loss and postoperative drainage volume of the two groups were compared during the perioperative period.The incidence of postoperative complications was compared.Pain and dysfunction were compared with VAS score and ODI score of lumbar and back before,after and at the last follow-up in the two groups.Imaging parameters were compared between the two groups in terms of intervertebral space height,lordosis angle,spondylolisthesis rate before,after,1 year after and 2 years after operation and intervertebral bone graft fusion rate after operation.Results:There was no significant difference in gender,age,body mass index and operative segment between the two groups.The difference in operation time between the two groups was statistically significant(P<0.05).There was no significant difference in intraoperative blood loss and postoperative drainage.There was no significant difference in postoperative complications between the two groups.VAS score and ODI score of lumbar and back in the two groups were significantly improved after operation and the last follow-up compared with before operation,and the difference was statistically significant(P<0.05),and there was no significant difference between the two groups.The postoperative intervertebral height,lordosis angle and spondylolisthesis rate of the two groups were significantly improved compared with those before operation(P<0.05),and there was no significant difference between the two groups.The intervertebral height loss occurred in both groups after operation,and the loss value was statistically significant(P<0.05).There was no significant difference in intervertebral fusion rate between the two groups.Conclusion:For patients with degenerative lumbar spondylolisthesis,laminectomy via posterior lumbar approach,spinal canal decompression,reduction and interbody bone graft fusion(cage)pedicle internal fixation can significantly improve the symptoms of the patients and achieve good clinical efficacy.Single cage has obvious advantages in operation time,and double cage has obvious advantages over single cage in maintaining the intervertebral height of the fusion segment after surgery.