[The application of three lumbar fusion methods in the treatment of spondylolisthesis].

OBJECTIVE: to compare the therapeutic effect of posterolateral fusion (PLF), posterior lumbar interbody fusion (PLIF) and posterior circumferential fusion (PCF) for lumbar spondylolisthesis. METHODS: from January 2003 to December 2008, 232 patients with lumbar spondylolisthesis treated with pedicle screw fixation and followed for reviewed retrospectively. The patients were divided into three groups based on fusion method: group A (PLF, 66 case), group B (PLIF, 54 case)and group C (PCF, 112 case). The three groups were reviewed and compared for clinical outcome and fusion rate. RESULTS: the mean follow-up period was 21 months (range, 6-60 months). The fusion rate was 80.1% for PLF, 92.5% for PLIF and 93.7% for PCF group (P > 0.05). As to isthmic spondylolisthesis or Meyerding grade degenerative II and III spondylolisthesis, the fusion rate was 60.7% for PLF group, 90% for PLIF group and 93.3% for PCF group (P < 0.05). Compare the fusion rate for PLF group and PLIF+ PCF group (P < 0.05), fusion rate for PLIF group and PCF group (P > 0.05). The rate of excellent and good together was 84.8% in PLF group, 90.7% in PLIF group and 93.6% in PCF group (P > 0.05). CONCLUSIONS: posterior lumbar interbody fusion and posterior circumferential fusion are more consistent with bio-mechanics, have a higher fusion rate, for the treatment of spondylolisthesis they are the preferred surgical approaches.