Analysis of long-term results of degenerative lumbar spondylolisthesis with posterior fusion

[Objective]To investigate the long-term results of posterior fusion in the treatment of degenerative lumbar spondylolisthesis. [Methods]Sixty-two patients suffered from degenerative lumbar spondylolisthesis with complete information underwent posterior decompression,fusion,reduction and fixation with pedicle screw system between January 2001 and July 2005.Fusion methods included posterolateral lumbar fusion(PLF),posterior lumbar interbody fusion(PLIF) with autologous ilium and PLIF with Cage.They were followed up for 5 to 9 years(average,6.4 years).The JOA scores recovery rate,excellent and good results,satisfaction degree,fusion rate and adjacent segment degeneration were evaluated.The preoperative,postoperative and the last follow-up of slip rate,intervertebral height,disc angle and segmental scoliosis angle were compared and analyzed.[Results]The JOA scores recovery rate was 67.7±19.4%,the excellent and good results was 85.5%,the satisfaction degree was 87.1%,the fusion rate was 95.2%.Tweenty-six patients(41.9%) developed adjacent segment degeneration or increased degeneration.There were no significant differences between the three fusion methods(P0.05).The slip rate,intervertebral height,disc angle and segmental scoliosis angle were improved significantly postoperatively than preoperatively(P0.05).Spondylolisthesis reduction,intervertebral height and disc angle lost a little at the time of last follow-up,and PLIF with Cage had little loss.[Conclusion]Posterior decompression,fusion,reduction and fixation with pedicle screw system can achieve good long-term results in treatment of degenerative lumbar spondylolisthesis.PLIF with Cage can have a better radiographic improvement.