Abstract:
The armamentarium of surgical treatment options for lumbar spondylolisthesis (LS) includes decompression alone, stabilization with interlaminar devices, or instrumented fusion, through open or minimally invasive approaches. Despite its safe profuse use in distinctive lumbar spine disorders, using percutaneous pedicle screws (PPSs) alone to stabilize LS has never been described before. We performed a retrospective study of prospectively collected data, enrolling 24 patients with LS and scrutinizing clinical and radiological outcomes. A statistically significant decrease in visual analog scale (VAS) scores (p < 0.001) and Oswestry Disability Index (ODI) scores (p < 0.001) was observed, as was a reduction in the intake of acetaminophen after surgery (p = 0.022). In the long-term, PPS effectively reduced the index-level range of motion (p < 0.001), reduced preoperative slippage (p = 0.03), and maintained foraminal height, thus accounting for the positive clinical outcomes. It induced a significant segmental kyphotic effect (p < 0.001) that was compensated for by a favorable increase in the pelvic incidence minus lumbar lordosis (PI-LL) index (0.028).
摘要:
腰椎滑脱症(LS)的手术治疗方案包括单纯减压,用层间装置稳定,或者仪器融合,通过开放或微创方法。尽管它在独特的腰椎疾病中安全使用,以前从未描述过单独使用经皮椎弓根螺钉(PPSs)来稳定LS。我们对前瞻性收集的数据进行了回顾性研究,纳入24例LS患者,并仔细检查临床和放射学结果。观察到视觉模拟量表(VAS)评分(p<0.001)和Oswestry残疾指数(ODI)评分(p<0.001)的统计学显着下降,手术后对乙酰氨基酚的摄入量减少(p=0.022).从长远来看,PPS有效地降低了指数水平的运动范围(p<0.001),术前滑移减少(p=0.03),并保持椎间孔高度,从而解释了积极的临床结果。它诱导了显着的节段性后凸作用(p<0.001),并通过骨盆发病率减去腰椎前凸度(PI-LL)指数(0.028)的有利增加来补偿。