Two kinds of posterior intervertebral fusion for lumbar spondylolisthesis: fusion rate and height of intervertebral loss

doi:10.3969/j.issn.2095-4344.2015.35.011

Abstract

Abstract:

BACKGROUND: The major aim of repair of lumbar spondylolisthesis is to restore and reconstruct the stability of spine sequence, and to relieve compression of herniated disc on nerve root. Pedicle screw system and bone graft fusion become the preferred way to treat spondylolisthesis of most scholars. Most scholars are prone to posterior interbody fusion or posterolateral interbody fusion.
OBJECTIVE: To compare the clinical curative effects of posterior autologous iliac bone graft fusion and posterior Cage intervertebral bone graft fusion in patients with degenerative lumbar spondylolisthesis by observing fusion rate and height of intervertebral loss.
METHODS: A total of 61 patients with degenerative lumbar spondylolisthesis in Xuancheng Central Hospital from July 2008 to December 2013 were enrolled in this study. According to the different types of interbody fusion, 37 cases in autologous ilium group received posterior autologous iliac bone graft fusion. 24 cases in the Cage interbody fusion cage group underwent posterior Cage interbody fusion cage fusion. Operation time, blood loss, spondylolisthesis reduction, graft fusion and Japanese Orthopaedic Association score were compared between
the two groups. The significance of different fusion manners on prognosis was explored in patients with degenerative lumbar spondylolisthesis.
RESULTS AND CONCLUSION: No significant difference in blood loss was detected between the two groups (P > 0.05). However, the operation time was significantly longer in the autologous ilium group than in the Cage interbody fusion cage group (P < 0.05). The reduction rate, bone graft fusion rate and improvement rate of clinical curative effects were good in both groups, and no significant difference was detectable in above indexes between the two groups (P > 0.05). Significant difference in the height of intervertebral loss was detectable between the two groups in final follow-up (P < 0.05). The height of intervertebral loss was better in the Cage interbody fusion cage group than in the autologous ilium group. These findings indicate that two kinds of bone graft fusion manners for lumbar spondylolisthesis obtained good reduction and clinical curative effects, but the height of intervertebral loss was small in the Cage interbody fusion cage fusion during long-period follow-up, and the clinical effect was good.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

Key words: Spondylolysis, Ilium, Spinal Fusion, Blood Loss, Surgical

CLC Number:

R318

He Cheng-wen, Bai Rui-jun. Two kinds of posterior intervertebral fusion for lumbar spondylolisthesis: fusion rate and height of intervertebral loss [J]. Chinese Journal of Tissue Engineering Research, 2015, 19(35): 5630-5635.

Figures/Tables 6

References

[1] Herkowitz HN. Spine update: Degenerative lumbar spondylolisthesis. Spine.1995;20: 1084-1090.
[2] Figueiredo N, Martins JW, Arruda AA, et al. Tlif: Transforaminal lumbar interbody fusion. Arq Neuropsiquiatr. 2004;62(3B):815-820.
[3] 汤志兵,杨惠林,陈康武.轻度峡部裂性滑脱症的治疗进展[J].中国脊柱脊髓杂志,2012, 22(10): 951-954.
[4] Kuang L, Xu D, Li G, et al. Surgical treatment of lumbar spondylolisthesis by transforaminal lumbar interbody fusion. Zhonghua Yi Xue Za Zhi. 2014;94(29): 2293-2296.
[5] 黄剑峰,宁锦龙,岑定善,等.两种椎间融合方式在治疗腰椎滑脱症中的应用研究[J].中华临床医师杂志(电子版),2012,6(10): 2819-2822.
[6] Lee CK, Vessa P, Lee JK. Chronic disabling low back pain syndrome caused by internal disc derangements.The results of disc excision and posterior lumbar interbody fusion. Spine. 1995;20: 356-361.
[7] Santos ER, Goss DG, Morcom RK, et al. Radiologic assessment of interbody fusion using carbon fiber cages. Spine. 2003;28: 997-1001.
[8] Satomi K, Hirabayashi K, Toyama Y, et al. A clinical study of degenerative spondylolisthesis. Radiographic analysis and choice of treatment]. Spine. 1992;17(11): 1329-1336.
[9] 王展,王文己.后外侧植骨融合与360°环周融合修复腰椎滑脱症的Meta分析[J].中国组织工程研究,2014,18(53): 8685-8692.
[10] Zhou ZJ, Zhao FD, Fang XQ, et al. Meta-analysis of instrumented posterior interbody fusion versus instrumented posterolateral fusion in the lumbar spine. J Neurosurg Spine. 2011;15(3): 395-310.
[11] Park Y, Ha JW, Lee YT, et al. Minimally invasive transforaminal lumbar interbody fusion for spondylolisthesis and degenerative spondylosis: 5-year results. Clin Orthop Relat Res. 2014;472(6):1813-1823.
[12] Liu XY, Wang YP, Qiu GX, et al. A systematic review with meta-analysis of posterior interbody fusion versus posterolateral fusion in lumbar spondylolisthesis. Eur Spine J.2014;23(1):43-56.
[13] Zhao J, Zhang F, Chen X, et al. Posterior interbody fusion using adiagonai cage with unilateral transpedicular screw fixation for lumbar stenosis. Clin Neurosci. 2011;18: 324-328.
[14] 张庆明,沈惠良,曹立,等.颗粒骨打压植骨在腰椎后路融合手术中的应用[J].中国矫形外科杂志,2008,16(11):801-806.
[15] Wang JC, Mummaneni PV, Haid RW. Current treatment strategies for the painful lumbar motion segment: Posterolateral fusion versus interbody fusion. Spine. 2005; 30(16):S33-43.
[16] 秦彦超,马迅.两种椎间融合方法治疗腰椎滑脱症的疗效比较[J]. 山西医科大学学报,2010,41(5):458-461.
[17] 王晖,吴小涛,熊传芝,等.后路椎弓根内固定椎体间融合术治疗腰椎滑脱症[J].解剖与临床,2007,12(1):35-39.
[18] 海涌,陈晓明,陈志明,等.后路椎间融合术治疗成人腰椎滑脱的前瞻性研究[J].中华骨科杂志, 2004, 24(10):586-589.
[19] 周焕河,贺斌,吴春富,等.经前路椎间植骨融合治疗腰椎滑脱疗效分析[J].吉林医学,2013,33(8):1634-1635.
[20] 杨大鹏.经前路椎间植骨融合治疗腰椎滑脱的手术方法及效果观察[J].中国医药指南, 2013,11(13):570-571.
[21] Lin TY, Liao JC, Tsai TT, et al. The effects of anterior vacuum disc on surgical outcomes of degenerative versus spondylolytic spondylolisthesis: At a minimum two-year follow-up. BMC Musculoskelet Disord. 2014;15: 329.
[22] 夏志宏,管国义,项征.后路钉棒系统内固定加椎间植骨融腰椎滑脱症临床分析[J].现代中西医结合杂志, 2015, 24(6): 661-662.
[23] 朱国军. Cage植骨融合治疗退行性腰椎滑脱症疗效观察[J]. 现代中西医结合杂志,2015, 24(4):404-406.
[24] Nam WD, Cho JH. The importance of proximal fusion level selection for outcomes of multi-level lumbar posterolateral fusion. Clin Orthop Surg.2015;7(1):77-84.
[25] Sato J, Ohtori S, Orita S, et al. Radiographic evaluation of indirect decompression of mini-open anterior retroperitoneal lumbarinterbody fusion: oblique lateral interbody fusion for degenerated lumbar spondylolisthesis. Eur Spine J. 2015. [Epub ahead of print]
[26] Hao Y, Yu L, Zhang Y, et al. [Effectiveness of transforaminal lumbar interbody fusion via Luxor retractor associated with Mantis pedicle screw in treatment of moderate and severe lumbar spondylolisthesis]. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2014;28(12):1509-1513.
[27] Feng Y, Chen L, Gu Y, et al. Restoration of the spinopelvic sagittal balance in isthmic spondylolisthesis: posterior lumbarinterbody fusion may be better than posterolateral fusion. Spine J. 2015;15(7):1527-1535.
[28] Jiang WY, Xu RM, Ma WH, et al. [Effect of reduction on spino-pelvic parameters in treating high-grade lumbar spondylolisthesis].Zhongguo Gu Shang. 2014;27(9):726-729.
[29] Yamashita T, Sakaura H, Miwa T, et al. Modified posterior lumbar interbody fusion for radiculopathy following healed vertebral collapse of the middle-lower lumbar spine. Global Spine J. 2014;4(4):255-262.
[30] Gille O, Challier V, Parent H, et al. Degenerative lumbar spondylolisthesis: cohort of 670 patients, and proposal of a new classification. Orthop Traumatol Surg Res. 2014;100(6 Suppl):S311-315.
[31] Takahashi T, Hanakita J, Watanabe M, et al. Lumbar alignment and clinical outcome after single level asymmetrical transforaminal lumbarinterbody fusion for degenerative spondylolisthesis with local coronal imbalance. Neurol Med Chir (Tokyo). 2014;54(9):691-697.
[32] Liao JC, Lu ML, Niu CC, et al. Surgical outcomes of degenerative lumbar spondylolisthesis with anterior vacuum disc: can theintervertebral cage overcome intradiscal vacuum phenomenon and enhance posterolateralfusion? J Orthop Sci. 2014;19(6):851-859.
[33] Ding Y, Zhang W, Duan L, et al.[Effectiveness study on minimally invasive transforaminal lumbar interbody fusion assisted with microscope in treatment of lumbar spondylolisthesis. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2014;28(5):535-539.
[34] Morishita Y, Maeda T, Ueta T, et al. Pathophysiological effects of lumbar instrumentation surgery on lumbosacral nerve roots in the vertebral foramen: measurement of local pressure of intervertebral foramen. Spine (Phila Pa 1976). 2014;39(21): E1256-1260.
[35] 赵凤东,杨伟,刘军辉,等.经椎间孔腰椎椎体问融合术后融合器移位及其危险因素分析[J].中华骨科杂志,2012,32(10):922-927.