Clinical Effect Analysis Of PLIF And 360 Degree Fusion For Degenerative Lumbar Spondylolisthesis

Objective To investigate the difference between the clinical efficacy and postoperative imaging between 360 degree fusion and PLIF after single-level decompression for degenerative lumbar spondylolisthesis.Methods A total of 44 patients with degenerative lumbar spondylolisthesis who underwent PLIF or 360 degree circumferential fusion from September 2017 to January 2019were enrolled.19 patients underwent PLIF,including L_4-5-5 10 cases,L₅-S₁ 9 cases,25 patients underwent 360 degree fusion,including L_4-5-5 15 cases and L₅-S₁ 10 cases.All medical records retain complete preoperative and postoperative imaging data,including preoperative and final follow-up spiral CT and lumbar spine anterolateral radiographs,archiving image and system of communication.The parameters were measured according to the above system:operation duration,intraoperative blood loss,postoperative extubation time and postoperative discharge time,intervertebral space height difference(The intervertebral space heights at three points of L_4-5,L₅-S₁ before surgery and at three points of L_4-5,L₅-S₁ after surgery were compared,and their differences were averaged to reduce errors.).Bone graft fusion and adjacent vertebral disease?osteophyte formation,loss of height height,erosion of subchondral bone,remodeling of joint process and even fusion of joint process?were found in adjacent joints.Before and after surgery the VAS scores of patients and at the last follow-up.The patients were divided into group A:PLIF;group B:360 degree fusion;the operation duration,intraoperative blood loss,postoperative extubation time,postoperative discharge time,intervertebral space height difference,bone graft fusion,adjacent vertebral disease and VAS score were compared between group A and group B according to statistical data.Results After the relevant surgical intervention for the patients with degenerative lumbar spondylolisthesis,we found that the different surgical methods applied to the patients were related to the time when the patients completed the operation,the total amount of bleeding during the operation,the appropriate extubation time after the operation,the time when the patients were discharged from the hospital after the operation,the incidence of adjacent vertebral disease after the operation,the rate of bone graft fusion and the difference of intervertebral space height.For patients with degenerative lumbar spondylolisthesis below Meyerding II degree,although PLIF has a lower recovery of intervertebral space height than360 degree fusion,the operation time is shorter,the total intraoperative blood loss is less,the time of extubation can be given early after surgery,the time of recovery in hospital after surgery is shorter,and the incidence of adjacent vertebral disease,fusion rate and VAS score after surgery are not significantly different.Conclusion?1?.PLIF is preferred for degenerative lumbar spondylolisthesis patients with Meyerding I degree?II degree.?2?.PLIF and 360 degree fusion for lumbar spondylolisthesis Meyerding degree I and II can achieve ideal surgical results,but they need to be rationally selected according to the patient's own conditions or other circumstances to ensure the improvement of treatment effect.