Efficacy analysis of two internal fixation systems in the treatment of lumbar isthmic spondylolisthesis with mild slippage

English Keywords:Lumbar spondylolisthesis  Spondylolysis  Internal fixation  Treatment effect

English Abstract:

  【Abstract】 Objectives: To compare and analyze the efficacies of Hoist and conventional internal fixation systems in treating lumbar isthmic spondylolisthesis with mild slippage. Methods: Patients diagnosed in our hospital with lumbar isthmic spondylolisthesis of Meyerding grade Ⅰ or Ⅱ(mild slippage) between December 2018 and December 2020 were retrospectively analyzed and divided into two groups according to the type of internal fixation. Group A used Hoist internal fixation system(an internal fixation system by propping, lifting and resetting)， and group B used conventional internal fixation system. A total of 38 patients were collected， including 18 in group A and 20 in group B. The clinical efficacy of the two groups was evaluated by comparing the data of the operation time, intraoperative blood loss, postoperative drainage, and the rate of slippage, angle of slippage, height of intervertebral space, and lumbar lordosis angle obtained by imaging examination, and the visual analogue scale(VAS) score, Oswestry disability index(ODI)， and Japanese Orthopaedic Association(JOA) score. Results: All 38 patients were operated successfully, and there were no statistical differences in sex, age, duration of illness, responsible segment, grade of slippage, preoperative slippage rate, and preoperative comorbidities between the two groups(P>0.05). There were no significant statistical differences between the two groups in intraoperative blood loss and postoperative drainage volume(P>0.05), but the operation time of group A was less than that of group B(160.8±15.3min vs 184.6±26.9min, P<0.01). The postoperative slippage rates in both groups were significantly smaller than the preoperative ones, and the postoperative slippage angle, the height of intervertebral space, and lumbar lordosis angle were greater than those before operation(P<0.01), while there was no significant difference in all these indicators between the two groups at each time point before or after operation(P>0.05). The postoperative VAS score and ODI were significantly lower than the preoperative ones in both groups(P<0.01), and the postoperative JOA scores were higher than the preoperative ones in both groups(P<0.01). There was no statistical difference in VAS score and JOA score between the two groups at different follow-up time points(P>0.05), but the ODI(％) in group A was lower than that in group B at 6 and 12 months after operation(18.1±3.2 vs 21.4±2.4；15.2±1.5 vs 16.8±2.0)(P<0.01). Conclusions: For patients with Ⅰ or Ⅱ grade lumbar isthmic spondylolisthesis, both Hoist internal fixation system and conventional internal fixation system are helpful to reset the slipped vertebrae, reconstruct the function of lumbar spine, obtain terminal interbody bony fusion, and improve the function of lumbar spine of patients significantly; the Hoist system can help reduce surgery time.