Long Term Clinical and Radiological Follow-up Study in Spondylolisthesis, Grade I : Decompression with or without Instrument

GradeⅠ요추부 척추 전방 전위증의 치료 : 감압성 후궁절제술과 고정기구 삽입술의 비교

  • Chung, Seung Young (Department of Neurosurgery, School of Medicine, Kyung-Hee University) ;
  • Kim, Gook Ki (Department of Neurosurgery, School of Medicine, Kyung-Hee University) ;
  • Lim, Young Jin (Department of Neurosurgery, School of Medicine, Kyung-Hee University) ;
  • Kim, Tae Sung (Department of Neurosurgery, School of Medicine, Kyung-Hee University) ;
  • Leem, Won (Department of Neurosurgery, School of Medicine, Kyung-Hee University) ;
  • Rhee, Bong Arm (Department of Neurosurgery, School of Medicine, Kyung-Hee University)
  • 정승영 (경희대학교 의과대학 신경외과학교실) ;
  • 김국기 (경희대학교 의과대학 신경외과학교실) ;
  • 임영진 (경희대학교 의과대학 신경외과학교실) ;
  • 김태성 (경희대학교 의과대학 신경외과학교실) ;
  • 임언 (경희대학교 의과대학 신경외과학교실) ;
  • 이봉암 (경희대학교 의과대학 신경외과학교실)
  • Received : 2001.09.05
  • Accepted : 2001.12.06
  • Published : 2001.12.31

Abstract

Objective : Controversy exists which surgical treatment better in lumbar grade I spondylolisthesis, decompressive laminectomy with or without lumbar instrumentation. Methods : Out of Sixty-four patients with lumbar spondylolisthesis underwent surgery, 18 patients operated with decompressive laminectomy alone and 44 patients with decompession and lumbar instrument, during recent 5-years between January, 1994 and December, 1998. The author studied a long term follow-up in the above two groups to analyzing the overall clinical outcomes in each group and to determining the incidence of pos-toperative radiologic instability. Results : 1) Overall postoperative symptoms improvement were not so different in both groups. 2) Postoperative progressive subluxation is more common after decompressive laminectomy without instrumentation than with instrumentation group. 3) Overall clinical outcomes were slightly better in decompressive laminectomy without instrumentation than with instrumentation group but there was no significant difference. 4) Postoperative radiologic changes did not seem to influence the patient-reported clinical outcomes. 5) Postoperative complications is more common in decompressive laminectomy with instrumentation group than without instrumentation group. Conclusion : In the surgical management of grade I spondylolisthesis, the efficiency and superiority of surgical treatments requires the cost effectiveness and risk/benefit analysis of decompressive laminectomy with or without instrumentation. Therefore, Further detailed studies of long term follow up in a large number of patients in each group are needed for choice of best treatment.

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