Percutaneous pedicle screw reduction and axial lumbar interbody fusion for lumbosacral spondylolisthesis

English Keywords:Axial lumbar interbody fusion  Percutaneous pedicle screw  Lumbosacral spondylolisthesis

English Abstract:

  【Abstract】 Objectives: To evaluate the clinical outcomes of percutaneous pedicle screws plus axial lumbar interbody fusion(AxiaLIF) for lumbosacral spondylolisthesis. Methods: From June 2010 to March 2013, 17 cases suffering from lumbar spondylolisthesis undergoing percutaneous pedicle screws plus axial lumbar interbody fusion were reviewed retrospectively. There were 8 males and 9 females with the age at time of surgery ranging from 33 to 58 years(mean, 43.7years). There were 5 degenerative spondylolisthesis, 11 spondylolysis spondylolisthesis and 1 traumatic lumbar spondylolisthesis. All cases were less than degree Ⅱ spondylolisthesis. The operation time，blood loss and complications were recorded．Radiography assessment included the Taillard index, slipping angle，intervertebral disc height and fusion rate. Visual analogue scale(VAS) was used for clinical assessment． Results: The average operation time was 140(range, 110-190) minutes and average intraoperative blood loss was 70(range, 60-150)ml． All case were followed up for 9 to 27 mouths(average, 14.5 mouths). Taillard index improved from 0.1632±0.0325 to 0.0716±0.007 at 1 week postoperatively and 0.0732±0.008 at final follow-up． Slipping angle decreased from 5.32°±1.37° to 2.14°±0.60° at 1 week postoperatively and 2.33°±0.50° at final follow-up. The intervertebral disc height increased from 4.78±1.43mm to 9.72±1.69mm at 1 week postoperatively and 9.68±1.18mm at final follow-up. There were statistical differences with respect to the Taillard index, slipping angle and intervertebral disc height between preoperation and 1 week postoperatively(P<0．05), while no statistical difference between 1 week postoperatively and final follow-up(P>0．05). Solid bony fusion was achieved under thin-section helical computed tomography(CT) scanning at 6 months follow-up. The VAS score of low back pain at preoperation and final follow-up was 7.34±1.56 and 0.73±0.68 respectively, During follow-up, leg pain and wound infection was noted in 2 cases respectively, cured after symptomatic treatment. Conclusions: Percutaneous pedicle screw reduction and axial lumbar interbody fusion is effective for lumbosacral spondylolisthesis due to its less invasive to the posterior structure, less intraoperative blood loss．