Instrumented and noninstrumented posterolateral fusion in adult spondylolisthesis -: A prospective randomized study:: Part 2
Instrumented and noninstrumented posterolateral fusion in adult spondylolisthesis -: A prospective randomized study:: Part 2
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DOI：
10.1097/00007632-200007010-00017
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发表时间：
2000-07-01
期刊：
影响因子：
3
通讯作者：
Hedlund, R
中科院分区：
文献类型：
--
作者：
Möller, H;Hedlund, R
研究设计.进行了一项前瞻性随机研究。确定经椎弓根内固定是否能改善成人峡部裂性腰椎滑脱患者后外侧融合的结果。经椎弓根固定的使用仍然存在争议。无论是积极的影响，并没有影响额外的经椎弓根固定已被证实。在本研究中，77例患者随机接受后外侧融合，其中37例采用经椎弓根固定，40例不采用经椎弓根固定。入选标准为任何级别的腰椎峡部裂性脊椎滑脱，至少1年的腰痛或坐骨神经痛，以及18至55岁的个体的严重功能受限。随访率为94%。在2年随访评估中，两组患者的疼痛和功能障碍程度非常相似，融合率无显著差异。腰椎后外侧融合原位治疗成人峡部裂性腰椎滑脱可缓解疼痛并改善功能。使用辅助经椎弓根内固定不会增加融合率或改善临床结局。
Study Design. A prospective randomized study was performed.Objective. To determine whether transpedicular fixation improves the outcome of posterolateral fusion in patients with adult isthmic spondylolisthesis.Summary of Background Data. The use of transpedicular fixation remains controversial. Both a positive effect and no effect from additional transpedicular fixation have been reported.Methods. In this study, 77 patients randomly underwent posterolateral fusion with (n = 37) or without (n = 40) transpedicular fixation. The inclusion criteria were lumbar isthmic spondylolisthesis of any grade, at least 1 year of low back pain or sciatica, and severely restricted functional ability in individuals 18 to 55 years of age.Results. The follow-up rate was 94%. At a 2-year follow-up assessment, the level of pain and functional disability were strikingly similar in the two groups, and there was no significant difference in fusion rate.Conclusions. Lumbar posterolateral fusion performed in situ for adult isthmic spondylolisthesis relieves pain and improves function. The use of supplementary transpedicular instrumentation does not add to the fusion rate or improve the clinical outcome.