Abstract:Objective: To investigate the clinical effect of posterior decompression and reduction of lumbar spine and circular fusion for the treatment of lumbar double-segment spondylolisthesis and the changes in the sagittal fitting relationship between lumbar spine and pelvis. Methods: A total of 67 patients with double-segment lumbar spondylolisthesis who underwent posterior decompression, reduction, circular fusion and internal fixation of the lumbar spine in the Department of Joint Trauma Surgery, First Affiliated Hospital of Hainan Medical College from January 2014 to January 2018 were retrospectively included in this study. The patient's preoperative and final follow-up for lumbar and leg pain visual analogue scale (VAS) and lumbar spine dysfunction Oswestry disability index (ODI) scores were recorded, and their lumbar lordosis (LL), sacral slope (SS), pelvic tilt (PT) and pelvic incidence (PI) were determined and comparatively analyzed. Results: Twelve months after the operation, the VAS score of the patient's low back pain decreased from (5.1±0.6) points to (2.1±0.5) points, and the ODI decreased from (44.5±2.2) points to (18.6±1.0) points. The differences between the two changes were all statistically significant (P<0.001) . LL decreased from 47.3°±5.1°to 32.1°±6.0°, SS decreased from 40.3°±3.3°to 26.8°±7.5°, PT decreased from 34.5°±3.0°to 13.6°±5.0°, and PI decreased from 63.2°±8.1°to 43.3°±6.6°, with significant differences among the four parameters (P<0.001) . There was no significant correlation between LL and SS, PT and PI before operation (P>0.05) . At 12 months postoperatively, LL was positively correlated with SS (P<0.05), SS was negatively correlated with PT (P<0.05), and SS was negatively correlated with PI (P<0.05) . Conclusion: Posterior lumbar decompression, reduction, circular fusion and internal fixation for the treatment of lumbar double-segment spondylolisthesis is beneficial to alleviate lumbar and leg pain, promote the recovery of spinal nerve function, and re store the lumbar-pelvic sagittal alignment.
