YANG Xi, SONG Yueming, KONG Qingquan, LIU Hao, LIU Limin, GONG Quan, LI Tao._Chinese Journal of Reparative and Reconstructive Surgery

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Traumatic lumbar spondylolisthesis;;
Clinical feature;;
Posterior fixation and fusion;

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Keywords：

创伤性腰椎滑脱症; 临床特征; 后路固定融合术

DOI：

10.7507/1002-1892.20130210

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Objective To analyze the clinical features and preliminary outcome of posterior operation for traumatic lumbar spondylolisthesis. Methods The clinical data of 11 patients with traumatic lumbar spondylolisthesis who underwent surgeries between January 2008 and June 2012 were retrospectively analyzed. There were 6 male and 5 female patients, aged from 13 to 60 years with a median age of 38 years. The mechanism of injury included heavy pressure injury in 4 cases, falling injury from height in 4 cases, and traffic accident injury in 3 cases. The time of injury to operation was between 3 days and 13 years (median, 20 days). According to Frankel neurological function grading, 2 patients were rated as grade E, 4 as grade D, 3 as grade C, and 2 as grade B before operation; according to Meyerding spondylolisthesis grading, 4 cases were classified as degree I, 4 as degree II, 2 as degree III, and 1 as degree IV preoperatively. The affected segments included L4 in 3 and L5 in 8 patients. The surgical fixation segments were L4, 5 in 2 patients, L5, S1 in 7, and L4-S1 in 2. Eight patients underwent circumferential fusion, while 3 patients underwent posterolateral fusion. The reduction of spondylolisthesis and bone graft fusion were assessed on X-ray films and three-dimensional CT scans during follow-up. The clinical outcomes were evaluated by visual analogue scale (VAS) and Oswestry disability index (ODI) scores. Results All patients achieved primary healing of incision after operation. And all patients were followed up 6-40 months with a median time of 12 months. There was no pulling-out or breaking of internal fixation. The fusion rate was 100% on three-dimensional CT scans, and the fusion time was 3-6 months (mean, 4.5 months). The spondylolisthesis was degree 0 in 10 cases and degree I in 1 case according to Meyerding grading, showing significant difference when compared with preoperative spondylolisthesis grading (Z= — 2.979, P=0.003). The Frankel neurological function grading were E in 6, D in 3, and C in 2 at last follow-up, which were significantly improved when compared with preoperative one (Z= — 2.271, P=0.014). At 1 week after operation and last follow-up, VAS and ODI scores were significantly improved when compared with the preoperative scores (P lt; 0.05); however, no significant difference was found between at 1 week and at last follow-up (P gt; 0.05). Conclusion If lumbar X-ray films suggest multiple fractures of transverses in emergency combined with the mechanism of injury, it bly indicates the diagnosis of traumatic lumbar spondylolisthesis, moreover earlier decompression and fusion can provide the recovering of the neurological function and satisfactory preliminary effectiveness in these patients.

Citation： Department of Orthopedics,West China Hospital,Sichuan University,Chengdu Sichuan,P.R.China. Corresponding author KONG Qingquan,Email kongspine.com. YANG Xi, SONG Yueming, KONG Qingquan, LIU Hao, LIU Limin, GONG Quan, LI Tao.. Chinese Journal of Reparative and Reconstructive Surgery, 2013, 27(8): 965-968. doi: 10.7507/1002-1892.20130210 Copy

1.	CLINICAL FEATURE AND P 1 Deniz FE, Zileli M, Cağli S, et al. Traumatic L4-L5 spondylolisthesis: case report. Eur Spine J, 2008, Suppl 2: S232-235.
2.	RELIMINARY SURGICAL OUTCOME OF TRAUMATIC LUMBAR SPONDYLOLISTHESIS.
3.	Vialle R, Wolff S, Pauthier F, et al. Traumatic lumbosacral dislocation: four cases and review of literature. Clin Orthop Relat Res, 2004, (419): 91-97.
4.	Tsirikos AI, Saifuddin A, Noordeen MH, et al. Traumatic lumbosacral dislocation. Spine (Phila Pa 1976), 2004, 29(8): E164-168.
5.	Vresilovic EJ, Mehta S, Placide R, et al. Traumatic spondylopelvic dissociation. A report of two cases. J Bone Joint Surg (Am), 2005, 87(5): 1098-1103.
6.	Roche PH, Dufour H, Graziani N, et al. Anterior lumbosacral dislocation: case report and review of the literature. Surg Neurol, 1998, 50(1): 11-16.
7.	Ahmed A, Mahesh BH, Shamshery PK, et al. Traumatic retrolisthesis of the L4 vertebra. J Trauma, 2005, 58(2): 393-394.
8.	Saiki K, Hirabayashi S, Sakai H, et al. Traumatic anterior lumbosacral dislocation caused by hyperextension mechanism in preexisting L5 spondylolysis a case report and a review of literature. J Spinal Disord Tech, 2006, 19(6): 455-462.
9.	Vialle R, Charosky S, Rillardon L, et al. Traumatic dislocation of the lumbosacral junction diagnosis, anatomical classification and surgical strategy. Injury, 2007, 38(2): 169-181.
10.	Fabris D, Costantini S, Nena U, et al. Traumatic L5-S1 spondylolisthesis: report of three cases and a review of the literature. Eur Spine J, 1999, 8(4): 290-295.
11.	Zhou TH, Tang X, Xu YQ, et al. Traumatic spondyloptosis of L4. Spine (Phila Pa 1976), 2010, 35(17): E855-859.
12.	Reinhold M, Knop C, Blauth M. Acute traumatic L5-S1 spondylolisthesis: a case report. Arch Orthop Trauma Surg, 2006, 126(9): 624-630.
13.	Lim CT, Hee HT, Liu G. Traumatic spondylolisthesis of the lumbar spine: a report of three cases. J Orthop Surg (Hong Kong), 2009, 17(3): 361-365.
14.	姜为民, 周峰, 唐天驷, 等. 急性创伤性腰椎滑脱. 中华创伤骨科杂志, 2003, 5(4): 395-396.
15.	Lu X, Hou C, Yuan W, et al. Complete traumatic anterior dislocation of the lumbosacral joint: a case report. Spine (Phila Pa 1976), 2009, 34(14): E488-492.
16.	El Assuity WI, El Masry MA, Chan D. Acute traumatic spondylolisthesis at the lumbosacral junction. J Trauma, 2007, 62(6): 1514-1516.
17.	刘鹏, 赵建华, 范伟力, 等. 急性创伤性腰椎滑脱症的临床特点与手术疗效分析. 创伤外科杂志, 2005, 7(4): 271-273.
18.	周田华, 汤逊, 徐永清, 等. 后路短节段固定加减压融合治疗下腰椎创伤性滑脱. 中国骨与关节损伤杂志, 2009, 24(4): 323-324.
19.	Wangtaphan W, Oo M, Paholpak P, et al. Traumatic lumbosacral spondyloptosis treated five months after injury occurrence: a case report. Spine (Phila Pa 1976), 2012, 37(22): E1410-1414.

1. CLINICAL FEATURE AND P 1 Deniz FE, Zileli M, Cağli S, et al. Traumatic L4-L5 spondylolisthesis: case report. Eur Spine J, 2008, Suppl 2: S232-235.
2. RELIMINARY SURGICAL OUTCOME OF TRAUMATIC LUMBAR SPONDYLOLISTHESIS.
3. Vialle R, Wolff S, Pauthier F, et al. Traumatic lumbosacral dislocation: four cases and review of literature. Clin Orthop Relat Res, 2004, (419): 91-97.
4. Tsirikos AI, Saifuddin A, Noordeen MH, et al. Traumatic lumbosacral dislocation. Spine (Phila Pa 1976), 2004, 29(8): E164-168.
5. Vresilovic EJ, Mehta S, Placide R, et al. Traumatic spondylopelvic dissociation. A report of two cases. J Bone Joint Surg (Am), 2005, 87(5): 1098-1103.
6. Roche PH, Dufour H, Graziani N, et al. Anterior lumbosacral dislocation: case report and review of the literature. Surg Neurol, 1998, 50(1): 11-16.
7. Ahmed A, Mahesh BH, Shamshery PK, et al. Traumatic retrolisthesis of the L4 vertebra. J Trauma, 2005, 58(2): 393-394.
8. Saiki K, Hirabayashi S, Sakai H, et al. Traumatic anterior lumbosacral dislocation caused by hyperextension mechanism in preexisting L5 spondylolysis a case report and a review of literature. J Spinal Disord Tech, 2006, 19(6): 455-462.
9. Vialle R, Charosky S, Rillardon L, et al. Traumatic dislocation of the lumbosacral junction diagnosis, anatomical classification and surgical strategy. Injury, 2007, 38(2): 169-181.
10. Fabris D, Costantini S, Nena U, et al. Traumatic L5-S1 spondylolisthesis: report of three cases and a review of the literature. Eur Spine J, 1999, 8(4): 290-295.
11. Zhou TH, Tang X, Xu YQ, et al. Traumatic spondyloptosis of L4. Spine (Phila Pa 1976), 2010, 35(17): E855-859.
12. Reinhold M, Knop C, Blauth M. Acute traumatic L5-S1 spondylolisthesis: a case report. Arch Orthop Trauma Surg, 2006, 126(9): 624-630.
13. Lim CT, Hee HT, Liu G. Traumatic spondylolisthesis of the lumbar spine: a report of three cases. J Orthop Surg (Hong Kong), 2009, 17(3): 361-365.
14. 姜为民, 周峰, 唐天驷, 等. 急性创伤性腰椎滑脱. 中华创伤骨科杂志, 2003, 5(4): 395-396.
15. Lu X, Hou C, Yuan W, et al. Complete traumatic anterior dislocation of the lumbosacral joint: a case report. Spine (Phila Pa 1976), 2009, 34(14): E488-492.
16. El Assuity WI, El Masry MA, Chan D. Acute traumatic spondylolisthesis at the lumbosacral junction. J Trauma, 2007, 62(6): 1514-1516.
17. 刘鹏, 赵建华, 范伟力, 等. 急性创伤性腰椎滑脱症的临床特点与手术疗效分析. 创伤外科杂志, 2005, 7(4): 271-273.
18. 周田华, 汤逊, 徐永清, 等. 后路短节段固定加减压融合治疗下腰椎创伤性滑脱. 中国骨与关节损伤杂志, 2009, 24(4): 323-324.
19. Wangtaphan W, Oo M, Paholpak P, et al. Traumatic lumbosacral spondyloptosis treated five months after injury occurrence: a case report. Spine (Phila Pa 1976), 2012, 37(22): E1410-1414.

Chinese Journal of Reparative and Reconstructive Surgery

YANG Xi, SONG Yueming, KONG Qingquan, LIU Hao, LIU Limin, GONG Quan, LI Tao.

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