|
|
Short-term analysis of decompression with or without fusion treatment for degenerative lumbar spondylolisthesis |
FU Guoyong1, BING Ailing2*, JIANG Kun1, SUN Liandong1 |
1 Pediatric Sugery, Binzhou Medical University Hospital, Binzhou 256603, Shandong, P.R.China; 2 Ward of Rheumatism and Immunology Department, Binzhou Medical University Hospital |
|
|
Abstract Objective To compare the short term effects of decompression with or without fusion in the treatment of degenerative lumbar spondylolisthesis. Methods A total of 105 patients underwent decompression with or without fusion. According to the inclusion and exclusion criteria, totally 78 patients were enrolled, including 52 patients with decompression without fusion and 26 patients with fusion. The data were collected and recorded including age, sex, hospital stay, operative blood loss, operation time, bedtime, bone fusion, preoperative and postoperative10 days, 3 months, last follow up VAS, preoperative and postoperative 3 months, last follow up ODI. The follow up time was more than 12 months. Results The operative blood loss, operation time, hospital stay, bedtime, complications, postoperative10 days VAS of decompression with fusion group were significantly higher than those without fusion (P<0.05). The VAS and ODI scores of the postoperative 3 months, last follow up were similar (P>0.05). Conclusion Decompression with or without fusion are safe and effective surgical methods for the treatment of degenerative lumbar spondylolisthesis. Decompression without fusion has less surgical trauma, less bleeding, less complications and less cost.
|
Received: 28 June 2019
|
|
|
|
|
[1] NEWMAN P H. Spondylolisthesis, its cause and effect[J]. Ann R Coll Surg Engl, 1955, 16(5):305-323. [2] 梁龙,朱立国,魏戌,等.退行性腰椎滑脱症:NASS循证医学指南解读[J].天津中医药大学学报,2019, 38(2):105-108. [3] KUO C C, MERCHANT M, KARDILE M P, et al. In Degenerative Spondylolisthesis, Unilateral Laminotomy for Bilateral Decompression Leads to Less Reoperations at 5 Years When Compared to Posterior Decompression with Instrumented Fusion: A Propensity Matched Retrospective Analysis[J]. Spine (Phila Pa 1976), 2019, 44(21):1530-1537. [4] YANG J S, HE B, TIAN F, et al. Accuracy of Robot-Assisted Percutaneous Pedicle Screw Placement for Treatment of Lumbar Spondylolisthesis: A Comparative Cohort Study[J]. Med Sci Monit, 2019, 25: 2479-2487. [5] 耿晓鹏,孙磊,王霞,等.单纯椎管减压术与椎管减压合并内固定融合术治疗退变性脊柱侧凸的前瞻性随机对照研究[J].中国矫形外科杂志,2016,24(13):1158-1163. [6] BLIZZARD D J, THOMAS J A. MIS Single-position Lateral and Oblique Lateral Lumbar Interbody Fusion and Bilateral Pedicle Screw Fixation: Feasibility and Perioperative Results[J]. Spine (Phila Pa 1976), 2018, 43(6):440-446. [7] WARASHINA H, KATO M, KITAMURA S, et al. The progression of osteoarthritis of the hip increases degenerative lumbar spondylolisthesis and causes the change of spinopelvic alignment[J]. J Orthop, 2019, 16(4):275-279. [8] PIETERS T A, LI Y I, TOWNER J E, et al. Comparative Analysis of Decompression Versus Decompression and Fusion for Surgical Management of Lumbar Spondylolisthesis[J]. World Neurosurg, 2019, 125:1183-1188. [9] WEINSTEIN J N, LURIE J D, TOSTESON T D, et al. Surgical versus nonsurgical treatment for lumbar degenerative spondylolisthesis[J]. N Engl J Med, 2007, 356(22):2257-2270. [10] SUN W, XUE C, TANG X Y, et al. Selective versus multi-segmental decompression and fusion for multi-segment lumbar spinal stenosis with single-segment degenerative spondylolisthesis[J]. J Orthop Surg Res, 2019, 14(1):46. [11] LIANG H F, LIU S H, CHEN Z X, et al. Decompression plus fusion versus decompression alone for degenerative lumbar spondylolisthesis: a systematic review and meta-analysis[J]. Eur Spine J, 2017, 26(12):3084-3095. [12] 朱勇,赵宏,邱贵兴.腰椎不稳的诊断和治疗进展[J].中国脊柱脊髓杂志,2009,19(2):150-153. [13] JANG J W, PARK J H, HYUN S J, et al. Clinical Outcomes and Radiologic Changes After Microsurgical Bilateral Decompression by a Unilateral Approach in Patients With Lumbar Spinal Stenosis and Grade I Degenerative Spondylolisthesis With a Minimum 3-Year Follow-Up[J]. Clin Spine Surg, 2016, 29(7):268-271. [14] BROWN M D, WEHMAN K F, HEIN A D. The Clinical Usefulness of Intraoperative Spinal Stiffness Measurements[J]. Spine, 2002, 27(9):959-961. [15] 陈丹祎,刘俊雄,王旭,等.单纯减压与减压融合手术治疗退变性腰椎滑脱荟萃分析[J].中国矫形外科杂志,2019,27(1):51-57. |
|
|
|