Surgical treatment of degenerative lumbar spondylolisthesis

Objective:To investigate the efficacy of posterior lumbar spinal canal decompression,reduction and fixation with screw and rod system,interbody fusion with cages or intertransverse process fusion in patients with degenerative lumbar spondylolisthesis.Method:Of 35 patients treated for degenerative lumbar spondylolisthesis,32 cases were gradeⅠlumbar spondylolisthesis and 3 were gradeⅡ.28 underwent semi-laminectomy decompression,intertransverse process fusion and fixation with screw and rod system,7 underwent full-laminectomy decompression,interbody fusion with cages and fixation with screw and rod system.Result:In 30 patients,neural compression symptoms were relieved within 2 weeks after the surgery,and the roentgenograms showed good localization of the internal fixators.The neural symptoms were aggravated in 5 patients postoperatively.4 patients had worsened symptoms of nerve root irritation,of which the symptoms were relieved after conservative treatment in 3 patients,and the screw and rod system was taken away 8 months after the surgery in 1 patient with unrelieved symptoms after the treatment.1 patient had paresis which was improved after re-operation.29 patients were followed up for 2 to 3.5 years.The complete reduction of the olisthy bodies,interbody fusion with cages or intertransverse process fusion were achieved in 27 cases.Slight further slippage was observed in 1 case 6 months after surgery.The localization of pedicle screws was altered in 1 case because of tumble,and the symptoms of nerve root irritation were relieved after the pedicle screws were taken out.According to the evaluation criterion of Zou Dewei,excellent outcomes were obtained in 20 cases,good in 7 cases,fair in 2 cases.The excellent and good rate was 93.1%.Conclusion:Posterior lumbar spinal canal decompression,reduction and fixation with screw and rod system,interbody fusion with cages or intertransverse process fusion are the effective techniques in the treatment of degenerative lumbar spondylolisthesis.