Surgical Results and Post-operative X-ray Findings in Lumbar Degenerative Spondylolisthesis Treated by Posterior Decompression without Fusion.

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During the past 12 years, we have surgically treated 73 patients with lumbar degenerative spondylolisthesis (DSL) using posterior decompression without fusion. All patients have been followed for more than one year (range; 1-10 years, mean; 3 years and 1 month). The average age at surgery was 63 years (range; 44 to 81 years).There were 34 male and 39 female patients. This study analysed the clinical symptoms, X-ray findings, operative results and factors influencing operative results in these patients. Laminectomy was done in 60 cases and fenestration in 13.Operative results were evaluated using the JOA score and Hirabayashi's average recovery rate was 79.8%. Reoperation was done in 2 cases. The cause of recurrence was new bone formation at the decompression site after fenestration. There were no cases in which symptoms recurred due to instability after decompression without fusion.Postoperative X-rays showed a decrease in the difference of the slip angle, but in some cases the slip ratio increased slightly. The recovery rate was less than 50%. In 7 cases, and in those four displayed severe palsy before operation. Symptoms recurred at other levels in one case and 1 case was complicated by severe osteoarthritis of the knee joints.We concluded that fusion operation in aged patients with DSL is not always necessary.
西日本整形・災害外科学会の論文