Clinical effect of lamina-pedicle screw fixation in the treatment of lumbar spondylolisthesis
ZHAO Yongjun1, BAI Chunhong1, SUN Minglin1, LI Zhonghai1, WU Jianxiang1, XIA Qun2, CHEN Tingting3
1. Department of Orthopaedics; 3. Department of Emergency Medicine,Characteristic Medical Center of Chinese People's Armed Police Force,Tianjin 300162, China; 2. Department of Orthopedics, Tianjin First Central Hospital, Tianjin 300192, China
Abstract：Objective To investigate the clinical efficacy of lamina-pedicle screw fixation in the treatment of lumbar spondylolisthesis. Methods Twenty-five patients with lumbar spondylolysis treated in our hospital between May 2018 and May 2021 were enrolled in our study. All these patients were military soldiers, whose lumbar spondylolisthesis was located at L5 and treated with lamina-pedicle screw fixation and isthmus bone graft. The Oswestry Disability Index (ODI) scores and visual analog scale (VAS) scores for back pain were used to assess the back pain before surgery and during follow-up visits. The bone graft fusion status was assessed based on the Lumbar X - ray and 3 - D CT scan. Results All the 25 cases underwent successful surgery and were followed-up until healing. The maximum postoperative follow-up was 14 months. The average duration of surgery was (75.12±15.41) min, the average blood loss was (123.31±20.81)ml, the hospital stay was (9.45±1.32)d, and the isthmic healing time was (7.68± 1.72) months.The postoperative VAS scores at 3 months and during the last follow-up were 3.42±1.10 and 1.36±1.03 respectively, being significantly different from preoperative VAS scores (P<0.05); The ODI indexes at 3 months after surgery and during the last follow-up(14.4%±4.5%、8.6%±6.7%) were significantly lower (P<0.05). The VAS pain score and ODI index during the last follow-up were both significantly lower than at 3 months postoperatively(P<0.05).The excellent and good rate was 100%. There were no such postoperative complications as infections, refractory lumbago, or fractures of internal fixation. Conclusions Lamina-pedicle screw fixation in the treatment of lumbar spondylolisthesis can effectively facilitate the relief of pain, dysfunction recovery, and the healing of spondylolisthesis.
Kreiner D S, Baisden J, Mazanec D J, et al. Guideline summary review: an evidence-based clinical guideline for the diagnosis and treatment of adult isthmic spondylolisthesis[J]. Spine J, 2016,16(12):1478-1485.
[2]
Rosenberg N J, Bargar W L, Friedman B.The incidence of spondylolysis and spondylolisthesis in nonambulatory patients[J].Spine (Phila Pa 1976),1981,6(1):35-38.
Huang Y, Liu J, Guo L, et al. “Temporary” short segment fixation in treating adolescent lumbar spondylolysis[J]. World Neurosurg, 2019,123:e77-e84.
[7]
Berjano P, Ristori G, Ismael M F, et al. A novel technique for spondylolysis repair with pedicle screws, rod and polyester band: case report with technical note and systematic literature review[J]. Spine (Phila Pa 1976),2020,45(24):1682-1691.
[8]
Jin M, Zhang J, Shao H, et al. Percutaneous endoscopic-assisted direct repair of pars defect without general anesthesia could be a satisfying treatment alternative for young patient with symptomatic lumbar spondylolysis: a technique note with case series[J]. BMC Musculoskelet Disord,2020,21(1):340.
Cho W, Le J T, Shimer A L, et al. Anatomy of lamina in the subaxial cervical spine with the special reference to translaminar screws: CT and cadaveric analysis with screw trajectory simulation[J]. Clin Spine Surg,2017,30(5): E535-E539.
[11]
Zeng Z Y, Zhang J Q, Mao K Y, et al. Channel-assisted fixation and interbody fusion in treating recurrent lumbar disc herniation by muscle-splitting approach[J].Zhongguo Gu Shang,2021,25;34(4):304-314.
Patel R D, Rosas H G, Steinmetz M P, et al. Repair of pars interarticularis defect utilizing a pedicle and laminar screw construct: a new technique based on anatomical and biomechanical analysis[J]. J Neurosurg Spine,2012,17(1):61-68.
[14]
Mohammed N, Patra D P, Narayan V,et al. A comparison of the techniques of direct pars interarticularis repairs for spondylolysis and low-grade spondylolisthesis: a meta-analysis[J].Neurosurg Focus,2018,44(1):E10.
[15]
Barakat A S, Soliman W S, Elgharabawy A F,et al. Repair of spondylolysis using a pedicle screw U-shaped rod construct: a preliminary study of 25 young patients with a mean follow-up of 24 months[J].J Craniovertebr Ju, 2021,12(2):170-177.
2022, Vol. 33 
