ABSTRACT
BACKGROUND:
Lumbar
decompression and fusion is the most effective surgical
method to treat lumbar degenerative
spondylolisthesis.In recent years,the sagittal balance of the
spine has been widely considered the key factor to adjust the outcome of spinal
surgery,and factors that can
affect the sagittal balance of the
spine indirectly
affect the surgical effect and
prognosis.
OBJECTIVE:
To summarize the
risk factors that can
affect the sagittal balance of the
spine during
decompression and fusion due to lumbar
spondylolisthesis,and
play a certain reference
role in the surgical
treatment of lumbar
spondylolisthesis.
METHODS:
With"lumbar
spondylolisthesis,the sagittal plane balance of the
spine,surgical
treatment,
risk factors"as the
Chinese search terms,and"lumbar
spondylolisthesis,sagittal balance,
risk factor"as the English search terms,
PubMed,Springer,ScienceDirect,Wanfang,VIP and CNKI were searched respectively.The focus of the search was from January 2010 to January 2023,and a few classic long-term articles were included.Preliminary
screening was conducted by
reading the title and abstract.After excluding repetitive
research in
Chinese and English
literature,low-quality journals and irrelevant
literature,67 articles were finally included for
review. RESULTS AND
CONCLUSION:
(1)Degenerative lumbar
spondylolisthesis is an important factor causing
spinal canal stenosis and lumbar instability,and is the main cause of
low back pain and
intermittent claudication.Lumbar
decompression,fusion and internal fixation is an effective way to treat degenerative lumbar
spondylolisthesis.(2)In the past,the
treatment of degenerative lumbar
spondylolisthesis with
decompression,fusion and fixation focused on thorough exploration and release of nerve roots,reduction of
spondylolisthesis and solid internal fixation,but less
attention was paid to the balance of sagittal plane of the
spine.(3)With the popularization of lumbar
decompression,fusion and internal fixation,
complications caused by the sagittal imbalance of the
spine gradually increased,resulting in poor
prognosis of
patients and even increased
risk of
secondary surgery.(4)Previous studies have only discussed the correlation between lumbar sagittal plane
parameters and spinal sagittal plane balance,but have not in-depth studied the relevant factors causing spinal sagittal plane imbalance.(5)Our results show that open lumbar fixation and fusion,complete reduction of
spondylolisthesis,selection of thicker
pedicle screws,selection of larger fusion cages,and autologous
bone transplantation are beneficial factors for maintaining sagittal balance.The higher the number of fusion segments,the higher the level of fusion segments is,which is a
risk factor for sagittal plane imbalance.
