gms | German Medical Science

Objective: To discuss the efficacy, advantages and disadvantages of isthmic fusion combined with TTL dynamic fixation through Wiltse approach for Meyerding I °lumbar isthmic spondylolisthesis.

Method: 10 cases who underwent isthmic fusion combined with TTL dynamic fixation through Wiltse approach served as study group and these patients underwent continual epidural anesthesia combined with local anesthesia intra-operatively. 20 cases who underwent traditional pedicle screws fixation, laminal hook fixation and isthmic fusion through mid-line approach served as control group and these patients underwent general anesthesia intra-operatively. Comparing and analyzing operation time, intra-operative blood loss, VAS of back pain and leg pain pre- and postoperative and the results of clinical and radiographic at follow-up.

Results: In the study group, the mean operation time was 65 ± 15 min, mean intra-operative blood loss was 20 ± 5 ml, the VAS of low back pain decreased from 6.5 ± 0.4 pre-operatively to 2.4 ± 1.1 post-operatively, the mean post-operative hospital stay was 3 days. In the control group, the mean operation time was 124 ± 25 min, mean intra-operative blood loss was 160 ± 70 ml, the VAS of leg pain decreased from 6.2 ± 0.3 pre-operatively to 1.2 ± 0.2 post-operatively, the VAS of low back pain from 6.3 ± 0.4 pre-operatively to 2.5 ± 0.9 post-operatively and the mean post-operative hospital stay was 5 days.

Conclusions: Isthmic fusion combined with TTL dynamic fixation through Wiltse approach is a safe and reliable method for the treatment for Meyerding I °lumbar isthmic spondylolisthesis. There was no significant difference in the results of both two groups. This new technique has more advantages than traditional surgery such as less invasion for paraspinal muscles, less blood loss, shorter recovery time and shorter hospital stay.