1.Department of Orthopedics, the Third Hospital of PLA, Baoji 721004, Shaanxi, China； 2. Department of Orthopedics, Xijing Hospital, the Fourth Military Medical University, Xi'an 710032, Shaanxi, China
Abstract: ObjectiveTo analyze the imaging changes in the patients with severe isthmic lumbar spondylolysis before and after surgical treatment and the diagnostic value.MethodsA total of 96 patients with severe isthmic lumbar spondylolysis admitted to our hospital during May 2008 to October 2016 were enrolled in the study. All patients were examined by Xray, CT and MRI. According to surgical treatment, 96 cases were divided into Y1, Y2 and Y3 group with 32 cases for each, and performed elective posterior lumbar decompression, pedicle screw internal fixation and interbody fusion respectively. The preand psotoperative imaging features were analyzed, and the treatment efficiency was compared. The pain degree and lumbar function were evaluated with the simplified McGill pain scale, Oswestry Disability Index (ODI) and the Japanese Orthopaedic Association (JOA) lumber assessment scale. The thoracolumbar kyphosis (TK), lumbar lordosis (LL), spinalpelvic angle (SSA), vertical distance from C7 to S1 posterior upper angle (SVA), sacral slope (SS), pelvic tilt (PT) and pelvic incidence (PI) were compared before and after surgery, and the postoperative complications were observed.ResultsThe Xray, CT and MRI exam showed characteristic findings for severe isthmic spondylolysis with detection rate of 44.79%，31.25% and 94.79% respectively. The lumbar fixation was stable and fusion was good in 6 months of followup after surgery. The total effective rates of group Y1, Y2 and Y3 was 84.37%, 87.50% and 90.62% respectively, and there was no statistical difference among them (P>0.05). Postoperative McGill scores and ODI were decreased, but JOA scores were increased in all groups (P<0.05), without statistical differences between groups (P>0.05). There was no statistical difference in TK and PI examined by Xray before and after surgery (P>0.05), while LL, SSA and SS were obviously increased (P<0.05), and the corrected angles were 16.01°, 20.77° and 9.95°, respectively. SVA and PT were significantly decreased, and the corrected value and angle were 5.19 cm and 8.49°respectively. There was no significant difference in the incidence of complications in the three groups (9.38% vs.12.50% vs. 12.50%, P>0.05).ConclusionExcept TK and PI, LL, SSA and SS in patients with severe isthmic spondylolysis are significantly increased, while SVA and PT are decreased after surgery, which can play an important role in the evaluation of prognosis.
乔林1，殷杰1，徐军鹏1，陈波1，张欢1，周玉萍1，王哲2. 重度腰椎峡部裂性滑脱手术治疗前后影像学变化：96例临床分析[J]. 中国现代手术学杂志, 2017, 21(5): 376-381.
QIAO Lin1, YIN Jie1, XU Junpeng1, CHEN Bo1, ZHANG Huan1, ZHOU Yuping1, WANG Zhe2. Imaging Changes before and after Surgical Treatment for Severe Isthmic Lumbar Spondylolysis : Clinical Analysis of 96 Cases. Chinese Journal of Modern Operative Surgery, 2017, 21(5): 376-381.
2017, Vol. 21 
