| BackdropThe term spondylolisthesis is from the Greek word "olisthanein",which first means "slip".Therefore,it mainly refers to the translation of one vertebral body on another,resulting in segmental instability.The most common one is degenerative lumbar spondylolisthesis((Ds),).Based on many published experimental articles and clinical viewpoints,it is basically believed that the current reliable treatment is conservative control in the early stage,and surgical treatment can be used as the final treatment when conservative treatment can not solve a series of problems of patients.The causes of pain in DS are various,from secondary mechanical low back pain to degenerative changes,to neurogenic claudication caused by spinal stenosis,and nerves caused by nerve root compression in the lateral recess or nerve foramen Radical pain is multifaceted.Decompression and fusion is currently the most commonly used surgical method for the treatment of lumbar spondylolisthesis.The classic scheme of spondylolisthesis is to add posterior internal fixation on the basis of interbody fusion cage and autologous or allogeneic bone graft.The use of posterior internal fixation has been shown to reduce the risk of false joints,that is,nonunion.However,with the people’s in-depth understanding of spinal surgery,the traditional decompression and fusion has also been found that there are more broken spinal structure,more complications and other shortcomings,therefore,to find a reliable alternative has also become the unshirkable responsibility and challenge of modern orthopedic surgeons.In recent decades,minimally invasive endoscopic technology began to show its unique advantages,this new surgical concept has brought good news for the majority of patients,and has gradually become the first choice for patients to consult doctors.However,the traditional minimally invasive surgery also has its limitations.Combined with the minimally invasive concept,this research group designed a modified PLIF procedure.The improved endoscopic surgery has achieved a stable and reliable effect in the treatment of lumbar spondylolisthesis,which is reported as follows.PurposeThis paper introduces and reports the efficacy of modified PLIF procedure based on minimally invasive concept in the treatment of single segmental lumbar spondylolisthesis.MethodForty-eight patients with single segmental lumbar spondylolisthesis treated in the Department of Orthopaedics,the first affiliated Hospital of Zhengzhou University from March 2019 to March 2020 were retrospectively analyzed.All patients underwent routine orthopedic examination before operation,the length of incision,the amount of intraoperative bleeding,the duration of operation and postoperative complications were counted,the height of intervertebral space,the degree of spondylolisthesis and the angle of spondylolisthesis were recorded,and the curative effect was evaluated by VAS score,ODI score and JOA score before and after operation.ResultsThe operation under the new light source electronic endoscope was completed smoothly,and the follow-up time was 6 to 19 months,with an average of(9.56±2.38)months.The average operation time was(118.06±17.97)min,at 90-159 min.The intraoperative blood loss was 50ml to 600ml,with an average of(246.25±121.05)mL.The postoperative incision length was 2.8mm to 3.5mm,with an average of(2.99±0.19mm)mm.The scores of VAS,ODI and JOA decreased from 6.52±0.87,85.71±4.83,12.90±1.53 before operation to 1.90±0.37,20.13±3.81,26.98±0.98at the last follow-up.There were significant differences in the height of intervertebral space,the degree of spondylolisthesis and the angle of spondylolisthesis before and after operation.The difference was statistically significant(P<0.01),and there was no complication after operation.ConclusionEndoscopic modified PLIF procedure for single-segment lumbar spondylolisthesis is effective,small incision and rapid recovery.It is a reliable surgical scheme for lumbar spondylolisthesis and is of great significance in the field of spine-related orthopaedics. |
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