|
|
Effect of lumbar interbody fusion combined with unilateral pedicle screw fixationfor treatment of degenerative lumbar spondylolisthesis |
WANG Xiushuang1, LIANG Xuefang2, SUN Yiqiang3, TIAN Shenglan3, GENG Xiaopeng3* |
1 Department of Spinal Joint,Huimin People's Hospital,Binzhou 251712,Shandong,P.R.China; 2 Huimin Maternal and Child Health Hospital,Binzhou 251700,Shandong,P.R.China; 3 Department of Spinal Surgery,Binzhou Medical University Hospital,Binzhou 256603,Shandong,P.R.China |
|
|
Abstract Objective To evaluate the effect of posterior lumbar interbody fusion combined with unilateral and bilateral pedicle screw fixation in treatment of single-level lumbar degenerative spondylolisthesis.Methods Fifty-two patients with single-level lumbar degenerative spondylolisthesis were treated with posterior lumbar interbody fusion combined with unilateral or bilateral pedicle screw fixation.According to the different fixation,they were divided into the unilateral group (25 cases) and the bilateral group (27 cases).The preoperative and postoperative visual analogue scale (VAS) and Oswestry disability index (ODI) scores,operation time,intraoperative blood loss,hospitalization costs and fusion rate were recorded and compared between the two groups.Results All patients completed the operation successfully and were followed up.At the last follow-up,VAS and ODI scores were significantly lower than those before surgery,P<0.01.The operation time,intraoperative blood loss and operation cost of patients in the bilateral group significantly increased,compared with those in the unilateral group,P<0.01.At the last follow-up,solid fusion was achieved in both groups.Conclusion The posterior lumbar interbody fusion combined with unilateral pedicle screw and bilateral pedicle screw fixation in treatment of single-level lumbar degenerative spondylolisthesis have comparable clinical outcomes,and unilateral pedicle screw has more advantages on operation time,intraoperative blood loss and hospitalization costs.
|
Received: 21 April 2020
|
|
|
|
|
[1] ZHAO Y,YANG S.Unilateral versus bilateral pedicle screw fixation in lumbar fusion:A systematic review of overlapping meta-analyses[J].PLoS One,2019,14:e0226848. [2] 丁一,潘爱星,张扬璞,等.后入路腰椎单侧或双侧椎弓根螺钉内固定术联合椎间融合术治疗腰椎退行性疾病研究进展[J].中国骨与关节杂志,2019,8(2):66-69. [3] LIU K,CHANG H,WANG L,et al.Risk factors for cage retropulsion after lumbar interbody fusion:systematic review and meta-analysis[J].World Neurosurg,2019,132:273-281. [4] WEN J,SHI C,YU L,et al.Unilateral versus bilateral percutaneous pedicle screw fixation in oblique lumbar interbody fusion[J].World Neurosurg,2020,134(3):920-927. [5] 汤旭日,马安军,傅弛,等.单侧椎弓根螺钉固定联合TLIF行腰椎融合术的中期疗效[J].中国矫形外科杂志,2017,25(5):410-415. [6] BERNARD F,MAZERAND E,GALLET C,et al.History of degenerative spondylolisthesis:from anatomical description to surgical management[J].Neurochirurgie,2019,65(1):75-82. [7] LU P,PAN T,DAI T,et al.Is unilateral pedicle screw fixation superior than bilateral pedicle screw fixation for lumbar degenerative diseases:a meta-analysis[J].J Orthop Surg Res,2018,13(1):296. [8] LI J,WANG W,ZUO R.Biomechanical stability before and after graft fusion with unilateral and bilateral pedicle screw fixation:finite element study[J].World Neurosurg,2019,123(2):228-234. [9] SHAH R R,MOHAMMED S,SAIFUDDIN A.Radiologic evaluation of adjacent superior segment facet joint violation following transpedicular instrumentation of the lumbar spine[J].Spine(Phila Pa 1976),2003,28(2):272-275. [10] CHEN C,CAO X,ZOU L,et al.Minimally invasive unilateral versus bilateral technique in performing single-segment pedicle screw fixation and lumbar interbody fusion[J].J Orthop Surg Res,2015,10(1):112. [11] CHEN D J,YAO C,SONG Q,et al.Unilateral versus bilateral pedicle screw fixation combined with transforaminal lumbar interbody fusion for the treatment of low lumbar degenerative disc diseases:analysis of clinical and radiographic results[J].World Neurosurg,2018,115(4):516-522. [12] 薛剑,靳安民,孙小平,等.单侧腰椎弓根螺钉及经椎板关节突螺钉固定与双侧固定的比较[J].中国组织工程研究,2013,22(9):1571-1578. [13] 陈继峰,盛伟斌,黄擘,等.单枚椎间融合器并椎弓根螺钉单侧内固定治疗单侧腰椎间盘突出症[J].中国组织工程研究,2013,(43):7552-7558. [14] CHEN S H,LIN S C,TSAI W C,et al.Biomechanical comparison of unilateral and bilateral pedicle screws fixation for transforaminal lumbar interbody fusion after decompressive surgery--a finite element analysis[J].BMC Musculoskelet Disord,2012,13(1):72. [15] GODZIK J,MARTINEZ-DEL-CAMPO E,NEWCOMB AGUS,et al.Biomechanical stability afforded by unilateral versus bilateral pedicle screw fixation with and without interbody support using lateral lumbar interbody fusion[J].World Neurosurg,2018,113(3):439-445. [16] 何蔚,张桦,何海龙,等.腰椎单侧及双侧椎弓根螺钉固定椎间融合器的生物力学研究[J].解放军医学杂志,2009,31(4):405-408. [17] SUK S I,LEE C K,KIM W J,et al.Adding posterior lumbar interbody fusion to pedicle screw fixation and posterolateral fusion after decompression in spondylolytic spondylolisthesis[J].Spine(Phila Pa 1976),1997,22(2):210-220. |
[1] |
FU Guoyong, BING Ailing, JIANG Kun, SUN Liandong. Short-term analysis of decompression with or without fusion treatment for degenerative lumbar spondylolisthesis[J]. 滨州医学院学报, 2020, 43(2): 97-100. |
[2] |
ZHANG Shouqiang, DOU Yongfeng, LI Jianjun, HU Peng, FU Guoyong, XING Jianqiang, WANG Guanglin, GENG Xiaopeng. Effect analysis of cortical bone trajectory screw for osteoporotic lumbar degenerative disease[J]. 滨州医学院学报, 2019, 42(4): 263-266. |
[3] |
NIU Chong, GENG Xiaopeng, WANG Xin, GAO Sheng, FANG Qingmin, SUN Zhaozhong, HU Peng. Improvement and application of a preoperative location method of percutaneous endoscopic lumbar discectomy[J]. 滨州医学院学报, 2018, 41(5): 343-346. |
[4] |
LIU Xin, SUN Zhaozhong, LI Rui, REN Jiabin, ZHENG Zhenyang, LI Lu. Comparison the postoperative wound reaction of the lumbar spondylolithesis treatment by OLIF and PLIF[J]. 滨州医学院学报, 2017, 40(2): 85-88. |
|
|
|
|