Tratamiento quirúrgico de la espondiolistesis lumbar degenerativa.(Polaco)

Katedra i Klinika Ortopedii, Akademia Medyczna im. K. Marcinkowskiego w Poznaniu, e-mail: klinikanch@op.pl.

Background and purpose: Degenerative lumbar spondylolisthesis occurs most often at the L4-L5 level and is characterized by anterior displacement of L4 vertebra on L5 vertebra. The aim of the study is to present both the decompression of nerve elements of the vertebral canal and the method of spine internal stabilization in patients with degenerative lumbar spondylolisthesis.

Material and methods: Clinical analysis comprises 11 patients treated surgically because of the degenerative spondylolisthesis. Intervertebral dislocation of more than 20% included 4 patients where the vertebral column stabilization was achieved by transpedicular stabilization as well as intervertebral and posterolateral spinal fusion (group I). In spondylolisthesis of less than 20% (4 patients) spondylodesis with intervertebral cages and posterolateral osseous grafts were carried out (group II). In the remaining 3 cases spondylolisthesis was smaller than 20% with denivelation of the intervertebral space (group III). There were nervous structures deliberated and spondylodesis was unnecessary.

Results: Low back pain and sciatic neuralgia were relieved in 9 (82%) patients. Neurological deficits were subsided completely in 7 (78%) cases.

Conclusions: The evaluation of the degree of vertebral displacement, height of the intervertebral space and assessment of vertebral column stability allowed to determine the strategy of surgery in patients with degenerative lumbar spondylolisthesis.