PERCUTANEOUS VERSUS OPEN SURGICAL FIXATION OF LUMBOSACRAL SPINE IN CASES OF DEGENERATIVE SPONDYLOLISTHESIS

M. Mohammed, Mohammed Al werdany, Shafik Tahseen El Molla, A. Farghaly, O. Ahmed
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Abstract

: Background and Objectives : Degenerative spondylolisthesis is frequently associated with LBP and leg pain. When conservative treatment fails to relief symptoms, the surgical spine fixation and neural tissue decompression becomes the treatment of choice as it leads to functional and symptomatic improvement. In this study we compare between percutaneous spine fixations versus open spine fixation in cases of degenerative spondylolisthesis. Patients and Methods : 40 patients with degenerative spondylolisthesis were divided randomly and equally in two groups, group A of patients underwent spine fixation with conventional open surgery approach, while group B underwent percutaneous spine fixation, we recorded intraoperative difficulties and post-operative outcome in the two groups every 6 months for 18 months. Results : The mean operation time was 174 minutes in group A and 168 minutes in group B, the mean amount of blood loss in group A was 443 ml, while was 165 ml in group B (p value < 0.001), the mean duration of hospital stay in group A was 2.45 days, while it was 1.8 day in group B (p value <0.002), there is no statistically significant difference between the two groups in reduction of leg pain, back pain and ODI either immediately post-operative or after 6, 12, and 18 months of follow up Conclusions : Percutaneous spine fixation has the advantage of being less invasive, with less intra operative bleeding, less operation time and post-operative hospital stay than the conventional open spine fixation technique. However, both techniques have the same results of improving patients’ leg and back pain on the long term.
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退行性椎体滑脱的腰骶椎经皮与开放手术固定比较
背景和目的:退行性脊柱滑脱通常与腰痛和腿部疼痛有关。当保守治疗不能缓解症状时,手术脊柱固定和神经组织减压成为治疗的选择,因为它可以改善功能和症状。在这项研究中,我们比较了经皮脊柱固定与开放脊柱固定在退行性脊柱滑脱的情况下。患者与方法:将40例退行性椎体滑脱患者随机平均分为两组,A组患者采用常规开放手术入路脊柱固定,B组患者采用经皮脊柱固定,每6个月记录两组患者术中困难及术后结果,共18个月。结果:在A组平均手术时间为174分钟和168分钟在B组,失血A组的平均数量是443毫升,165毫升在B组(p值< 0.001),A组的平均住院时间为2.45天,1.8天在B组(p值< 0.002),两组之间没有统计上的显著差异在减少腿部疼痛,背部疼痛和ODI术后立即或在6之后,12日和18个月的随访结论:经皮脊柱内固定与传统的开放式脊柱内固定相比,具有创伤小、术中出血少、手术时间短、术后住院时间短等优点。然而,从长期来看,这两种技术在改善患者腿部和背部疼痛方面的效果是相同的。
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