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| JIANG Weimin,WANG Genlin,YANG Huilin.Posterior revision surgery for failed lumbar spondylolisthesis[J].Chinese Journal of Spine and Spinal Cord,2010,20(1):11-14. |
| Posterior revision surgery for failed lumbar spondylolisthesis |
| Received:September 28, 2009 Revised:November 16, 2009 |
| English Keywords:Lumbar vertebra Spondylolishesis Revision surgery Posterior spinal surgery |
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| English Abstract: |
| 【Abstract】 Objective：To explore the clinical efficacy of individualized posterior revision surgery for failed lumbar spondylolisthesis.Method：The clinical data of 12 patients experiencing failed surgery due to lumbar spondylolisthesis were reviewed retrospectively from January 2004 to October 2007. 2 cases suffered from lumbar instability，1 case from lumbar spinal stenosis，4 cases from combined lumbar instability and stenosis，1 case from intervertebral disc herniation and 4 cases from bone graft nonunion.Instrument failure included screw loosening in 5 cases and screw broken in 3 cases，of 3 cases with screw broken，2 cases were complicated with perforation of cages into spinal canal，1 case had perforation of cages into spinal canal alone.Revision surgical procedures included pedicle screw plus bilateral cages implantation in 5 cases，pedicle screw plus unilateral cages implantation in 3 cases，unilateral pedicle screw plus unilateral cages implantation in 2 cases，single laminectomy and discectomy in 1 case，cage reimplantation while leaving pedicle screw intact in 1 case.All cases were followed up routinely.Radiography and Oswestry Disability Index（ODI） were used to evaluate the outcome of revision surgery.Result：All cases underwent revision surgery successfully with no neuroinjury noted.Only one case was complicated with cerebrospinal fluid leakage which was resolved 5 days later.The mean follow-up time was 2.7 years（range，1.5 to 4 years）.Bone graft union was evidenced in all cases without cages displacement，instrument failure and lumbar spondylolisthesis recurrence.The ODI was 81.8%±2.5% and 21.9%±3.0% for preoperation and follow-up respectively，which showed statistical significance between them（P<0.05）.Conclusion：Due to its complexity with regarding to failed lumbar spondylolisthesis，individualized posterior surgical protocols should be taken.Posterior spinal re-operation is one of effective procedure for failed lumbar spondylolisthesis. |
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