Efficacy comparison of the posterior lumbar intervertebral fusion combined with different intervertebral fusion methods in the treatment of single-level lumbar spondylolisthesis complicated with spinal stenosis

ObjectiveTo investigate the clinical efficacy of posterior lumbar interbody fusion(PLIF) combined with different intervertebral fusion in the treatment of single-segment lumbar spondylolisthesis(LS) complicated with lumbar spinal stenosis(LSS).

MethodsThe clinical data of 60 patients with LS complicated with LSS were retrospectively analyzed, and the patients were divided into the observation group(31 cases treated with tantalum cage combined with autograft bone) and control group(29 cases treated with autograft bone).The operation time, intraoperative blood loss, postoperative drainage and postoperative duration for bed rest in two groups were recorded.The visual analogue score(VAS), Oswestry dysfunction index(ODI), degree of spondylolisthesis, height of posterior margin of lumbar space and angle of lumbar lordosis in two groups were recorded throughout the treatment process.

ResultsThere was no statistical significance in the height of posterior margin of intervertebral space between two groups before and immediately after surgery(P>0.05), but the differences of which between two groups after 3 and 12 months were statistically significant(P < 0.01).There was no statistical significance in the lumbar lordosis angle between two groups before and immediately after surgery(P>0.05), but the differences of which between two groups after 3 and 12 months were statistically significant(P < 0.01).The degree of lumbar spondylolisthesis, posterior margin height of intervertebral space and lumbar lordosis angle in two groups were significantly improved immediately after operation, 3 months after operation and 12 months after operation(P < 0.01).There was no statistical significance in the waist VAS score in two groups between postoperation, and before and immediately after surgery(P>0.05), but the differences of which in two groups between after 3 and 12 months were statistically significant(P < 0.01).There was no statistical significannce in the leg VAS score in two groups among before operation, immediately after surgery and after 3 and 12 months of operation(P>0.05).There was no statistical significance in the ODI in two groups among before operation, immediately after operation and after 3 and 12 months of operation(P>0.05).The waist VAS score, leg VAS score and ODI score in two groups immediately after surgery, after 3 months and 12 months of surgery were significantly better than those before operation(P < 0.01).

ConclusionsThe PLIF combined with tantalum cage and autologous bone transplantation can maintain the lumbar lordosis angle and lumbar posterior margin height, and the long-term relief effects of lumbar pain of which is better than that of autologous bone transplantation alone.