The effects of preoperative imaging stability studies on intraoperative correction, postoperative observation, and clinical efficacy of adult lumbar spondylolisthesis treatment

Abstract

Background The aim of this study is to explore the use of preoperative imaging stability studies of adult lumbar spondylolisthesis and it's effects on intraoperative correction, postoperative observation, and clinical efficacy. Methods We retrospectively analyzed a total of 104 patients diagnosed with lumbar spondylolisthesis who underwent Posterior lumbar interbody fusion surgery between 2011 and 2014. The qualified patients were divided into two groups; group A (study/unstable group: 52 cases) and group B (control/stable group: 52 cases). Group A was further divided into group A1 (slip instability: 27 cases) and group A2 (angular instability: 25 cases). The preoperative lumbar sagittal plane translation distances and segmental angle of the preoperative lateral X-rays, hyperflexion X-rays, and hyperextension X-rays were measured and compared with their third-day postoperative lateral X-ray, and slip rate. The occurrences of intraoperative or postoperative complications, one-month postoperative follow-up data, including JOA, and VAS scores were access to evaluate the clinical efficacy of the treatment. Results Satisfactory postoperative radiographic correction was recorded in all groups. Better correction and correction was observed in group A1 patients and group B patients who used puller screws compared to those who used normal screws (P < 0.05). However, patients in group A2 who used normal pedicle screws had similar correction as those who used puller screws. The preoperative VAS scores showed that low back and lower extremity pain were higher in A1 and A2 groups compared to group B. However, they were lower one month postoperative. The preoperative JOA scores for the unstable groups (group A1 and A2) were lower than their stable counterpart but higher during the first month postoperative. Our analysis of postoperative complications also revealed no statistically significant difference between groups A1 and B, and groups A2, and B. Conclusions Preoperative imaging stability for adult lumbar spondylolisthesis does not affect intraoperative correction. The use of puller pedicle screws in patients with unstable or stable segmental slippage could achieve better correction and correction than with normal pedicle screws. The preoperative symptoms of patients with unstable segments were worse than their stable counterparts; however, their postoperative recovery was quicker in the first month postoperative.