Clinical efficacies of L5/S1 fixation fusion and L4 to S1 fixation with L5/S1 fusion in the treatment of L5 spondylolisthesis
Objective To compare the clinical efficacies of L5/S1 fixation fusion and L4 to S1 fixation with L5/S1 fusion in the treatment of L5 spondylolisthesis.Methods The clinical data of 132 patients with L5 spondylolisthesis who underwent posterior lumbar decompression reduction and bone graft fusion fixation in our department were retrospectively analyzed.According to the situation of surgical fixation and fusion,67 cases were enrolled into the short segment group(received L5/S1 fixation and fusion)and 65 cases were enrolled into the long segment group(received L4 to S1 fixation and L5/S1 fusion).The lumbar pain visual analogue scale(VAS)score,lumbar Oswestry disability index(ODI),lumbar lordosis,sacral slope,pelvic tilt and pelvic incidence before surgery and 12 months after surgery between the two groups were compared,and the incidence of complications between the two groups was compared.Results Compared with those before surgery,the lumbar VAS scores,lumbar ODI,lumbar lordosis,sacral slope,and pelvic incidence 12 months after surgery in the two groups were reduced and the pelvic tilt was increased,with statistically significant differences(P<0.05).There was no significant difference in the VAS lumbar score,lumbar ODI,sacral slope,pelvic tilt or pelvic incidence before surgery and 12 months after surgery between the two groups(P>0.05).The lumbar lordosis 12 months after surgery in the long segment group was greater than that in the short segment group,with statistically significant difference(P<0.05).There was no significant difference in the incidence of postoperative complications between the two groups(P>0.05).Conclusion L5/S1 fixation fusion and L4 to S1 fixation with L5/S1 fusion both can effectively treat L5 spondylolisthesis,and L4 to S1 fixation with L5/S1 fusion is more effective in restoring physiologic lumbar lordosis.
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