To analyze the effectiveness of posterior pedicle screw system combined with interbodyfusion in treating lumbar spondylol isthesis. Methods Between January 2005 and January 2009, 26 patients with lumbar spondylol isthesis underwent posterior pedicle screw system combined with interbody fusion, including 11 males and 15 females with an average age of 56.8 years (range, 36-73 years). The disease duration was 7 months to 11 years. The affected lumbars were L3 in 3 cases, L4 in 12 cases, and L5 in 11 cases. According to the Meyerding evaluating system, 21 cases were classified as degree III, 5 cases as degree III-IV, and 1 case as degree IV. The cl inical results were investigated by measuring radiographic measurements, including Taillard index, Boxall index, sl i pping angle, lumbar lordosis angle,and intervertebral height index preoperatively, immediately, 2 weeks and 3 months postoperatively, respectively. SUK’s criteria was used to judge bone graft fusion. Results Primary heal ing of the incisions was achieved in all cases. Allpatients were followed up 25.8 months on average (range, 10-51 months). There were significant differences in Taillardindex, Boxall index, sl i pping angle, lumbar lordosis angle, and intervertebral height index between preoperatively andimmediately, 2 weeks, 3 months after operation (P lt; 0.05). Bone graft fusion was achieved at 3-8 months after operation(mean, 3.5 months); and the fusion rate was 100%. According to Japanese Orthopedic Association (JOA) scoring, theresults were excellent in 17 cases, good in 7 cases, fair in 1 case, and poor in 1 case; and the excellent and good rate was 92.3%. Compl ications occurred in 2 cases, including nail or rod breakage and nerve injury, and they were cured aftertreatment. Conclusion Posterior pedicle screw system combined with interbody fusion treating lumbar vertebralspondylol isthesis can afford sol id internal fixation and achieve a satisfactory reduction, so it maybe an ideal procedure and a worthy recommended method for treating lumbar spondylol isthesis.
Objective To analyze the therapeutic effect of the posterior pedicle screw system combined with interbody fusion cage on lumbarspondylolisthesis. Methods From February 2003 to March 2006, 37 lumbar spondylolisthesis patients were treated with this operation, including21 males and 16 females and aging 3969 years.The affected lumbars were L3(3cases)，L4(23 cases), and L5(11 cases). According to the Meyerdingevaluating system, 12 cases were lassified as degree Ⅰ, 20 cases as degree Ⅱ,and 5 cases as degree Ⅲ. Taillard index, Boxall index, slipping angle, lumbar lordosis angle and intervertebral height index were measured before operation, and 2 weeks and 3 months after operation. Results All patients were followed up 336 months. There were statistically significant differences in Taillard index, Boxall index, slipping angle, lumbar lordosis angle and intervertebral height index between before operation and 2 weeks after operation (P＜0.05),and no statistically significant differences between 2 weeks and 3 months afteroperation(P＞0.05). According to Dewei Zhou’s creterior for scoring, the results were excellent in 27 cases， good in 8 cases，and fair in 2 cases. Theexcellent and good rate was 94.6%. All of the embedded osseous were fused. Thefusing time was from 3 to 8 months (mean 3-9 months). There were no breakageof screw and rod. The position and configuration of the whole cages were good. Conclusion Applying the posterior pedicle screw system combined with interbody fusion cage may achieve synergism in the treatment of lumbar vertebral spondylolisthesis. Above procedure is served as solid internal fixationand offers a satisfactory reduction, and can improve the fusion rate of the spine. So it is an ideal procedure and worthily recommended method for treatment oflumbar vertebral spondylolisthesis.