The effect of facet tropism on the clinical efficacy of posterior lumbar intervertebral fusion(PLIF)surgery in the treatment of degenerative spondylolisthesis
Objective To explore the effect of facet tropism(FT)on improving spinal parameters and clinical symptoms of degenerative lumbar spondylolisthesis(DLS)after posterior lumbar intervertebral fusion(PLIF)surgery.Methods Seventy-six DLS patients who received PLIF surgery in our hospital from January 2016 to December 2020 were retrospectively analyzed.The patients were divided into a non-facet tropism(NFT)group and a facet tropism(FT)group according to the difference of bilateral facet joint angles of more than 10°,38 in each group.The changes of clinical data before and after operation were compared between the two groups.The evaluation of imaging parameters included slippage percentage(SP),intervertebral height(IH),lumbar lordosis(LL),sacral slope(SS),pelvic tilt(PT),Cobb angle and range of motion(ROM)in lumbar spine.The evaluation of clinical symptoms in-cluded Visual Analogue Scale(VAS),Oswestry Disability Index(ODI)and MacNab classification.The correlation between the imaging parameters and symptom scores was assessed.The patients were also grouped according to different segments of preoperative FT,and the changes of imaging parameters and symptom scores were compared between each group and the control group.Results The average follow-up time was 23.63 months.The ROM in the FT group was lower than that in the NFT group(P＜0.05)while other preoperative clinical data were similar(P＞0.05).The imaging parameters and clinical symptom scores of the two groups after PLIF surgery were improved when compared with those before surgery.The postoperative LL and ROM in the FT group were lower than those in the NFT group(P＜0.01).The VAS score and ODI score of the FT group at follow-up were significantly higher than those of the control group(P＜0.01).Pearson correlation analysis showed that the correction of SP,IH,LL,SS and ROM was significantly related to the improvement of VAS and ODI in both groups(P＜0.05).The degree of LL correction in surgical segmental FT and multi-segment FT was significantly lower than that in the control group(P＜0.05).Conclusions PLIF surgery can restore the physi-ological curvature of lumbar spine and improve the symptoms of DLS.However,the ROM is limited after operation.FT hammers the lumbar spine correction.This is an important reason for the poor efficacy of PLIF surgery.
NETL
NSTL
万方数据
