腰椎滑脱症:植入物治疗现状及未来发展
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摘要
背景:腰椎滑脱是引起下腰腿疼痛的常见原因之一,是近年来脊柱退行性疾病中的研究热点。目的:腰椎滑脱的手术治疗方法多种多样,文章主要对近几年国内外关于腰椎滑脱症的手术治疗方法进行综述,旨在为腰椎滑脱症的手术方案提供参考。方法:以"腰椎滑脱,椎间融合,内固定治疗,手术治疗,椎弓根螺钉,spondylolisthesis,interbody fusion,internal fixation,operative treatment,pedicle screw"为检索词,分别检索1966年1月至2017年12月CNKI、PubMed数据库中与腰椎滑脱、腰椎滑脱症、脊柱不稳、脊柱侧弯等外科手术治疗相关的文章。根据入选标准及排除标准摘选53篇文献进行综述。结果与结论:(1)腰椎滑脱的外科手术治疗方式多种多样且各具利弊,联合术式往往可以取得相对好的预后结果;(2)手术方式的选择,不仅需要考虑患者的病情需要,也需要考虑术者自身更擅长哪种术式;(3)目前仍没有一种术式能被大家认可,相对于其他术式更具优势。
BACKGROUND: Spondylolisthesis is a most common cause of lumbocrural pain, which has been a hotspot in spinal degenerative diseases.OBJECTIVE: To summarize the surgical methods of lumbar spondylolisthesis at home and abroad, thus providing references for surgical scheme of spondylolisthesis.METHODS: The articles related to the surgical methods of spondylolisthesis, spinal instability and scoliosis published between January 1966 and December 2017 were retrieved from CNKI and PubMed databases. The keywords were "spondylolisthesis, interbody fusion, internal fixation, operative treatment, pedicle screw" in English and Chinese, respectively. Totally 53 eligible articles were enrolled based on the inclusion and exclusion criteria.RESULTS AND CONCLUSION:(1) There are various ways to the surgical treatment of spondylolisthesis and each of them has advantages and disadvantages. Combined surgery can obtain relatively good results.(2) Choosing an operation method not only needs to consider the patient requirements, but also needs to consider what kind of operation is more adept for the surgeons.(3) There is no a surgical method that can be recognized to be superior to the others.
BACKGROUND: Spondylolisthesis is a most common cause of lumbocrural pain, which has been a hotspot in spinal degenerative diseases.OBJECTIVE: To summarize the surgical methods of lumbar spondylolisthesis at home and abroad, thus providing references for surgical scheme of spondylolisthesis.METHODS: The articles related to the surgical methods of spondylolisthesis, spinal instability and scoliosis published between January 1966 and December 2017 were retrieved from CNKI and PubMed databases. The keywords were "spondylolisthesis, interbody fusion, internal fixation, operative treatment, pedicle screw" in English and Chinese, respectively. Totally 53 eligible articles were enrolled based on the inclusion and exclusion criteria.RESULTS AND CONCLUSION:(1) There are various ways to the surgical treatment of spondylolisthesis and each of them has advantages and disadvantages. Combined surgery can obtain relatively good results.(2) Choosing an operation method not only needs to consider the patient requirements, but also needs to consider what kind of operation is more adept for the surgeons.(3) There is no a surgical method that can be recognized to be superior to the others.
引文
[1]任杭岭,耿伟,马金柱,等.腰椎滑脱症患者手术前后脊柱-骨盆矢状位参数变化与临床疗效的相关性分析[J].中国修复重建外科杂志,2015,29(10):1269-1274.
[2]Pankowski R,Smoczynski A,Roclawski M,et al.Operative treatment of isthmic spondylolisthesis with posterior stabilization and ALIF.Cages versus autogenous bone grafts.Stud Health Technol Inform.2012;176:311-314.
[3]潘良春,黄彰,江华.腰椎滑脱症的治疗进展[J].创伤外科杂志,2009,11(3):278-280.
[4]西永明,贾连顺.退行性腰椎滑脱外科治疗中的相关问题[J].中国脊柱脊髓杂志,2006,16(1):65-67.
[5]Sengupta DK,Herkowitz HN.Degenerative spondylolisthesis:review of current trends and controversies.Spine(Phila Pa 1976).2005;30(6 Suppl):S71-S81.
[6]阮狄克,何勍,丁宇,等.单纯减压治疗伴Ⅰ度退变滑脱的腰椎管狭窄症的中远期疗效分析[J].中国脊柱脊髓杂志,2006,16(1):11-14.
[7]Johnsson R,Stromqvist B,Axelsson P,et al.Influence of spinal immobilization on consolidation of posterolateral lumbosacral fusion.A roentgen stereophotogrammetric and radiographic analysis.Spine(Phila Pa 1976).1992;17(1):16-21.
[8]Sairyo K,Katoh S,Sakamaki T,et al.Vertebral forward slippage in immature lumbar spine occurs following epiphyseal separation and its occurrence is unrelated to disc degeneration:is the pediatric spondylolisthesis a physis stress fracture of vertebral body?Spine(Phila Pa 1976).2004;29(5):524-527.
[9]Kanamori M,Yasuda T,Hori T,et al.Minimum 10-year follow-up study of anterior lumbar interbody fusion for degenerative spondylolisthesis:progressive pattern of the adjacent disc degeneration.Asian Spine J.2012;6(2):105-114.
[10]Inoue S,Watanabe T,Goto S,et al.Degenerative spondylolisthesis.Pathophysiology and results of anterior interbody fusion.Clin Orthop Relat Res.1988;227:90-98.
[11]陈守来,陈浩,陈明江,等.经前路椎体间植骨融合治疗腰椎滑脱[J].中国矫形外科杂志,2000,7(7):79-80.
[12]王慧敏,谭明生,李子荣,等.椎体间融合器治疗腰椎滑脱症[J].中国矫形外科杂志,2003,11(Z1):47-49.
[13]楚戈,白靖平,锡林·宝勒日,等.退变性腰椎滑脱的治疗进展[J].中国矫形外科杂志,2007,15(19):1486-1488.
[14]Klockner C,Weber U.Correction of lumbosacral kyphosis in high grade spondylolisthesis and spondyloptosis.Orthopade.2001;30(12):983-987.
[15]王建顺,王新虎,刘继军,等.椎弓根螺钉内固定结合椎体间植骨术治疗腰椎滑脱症的疗效观察[J].中国骨与关节损伤杂志,2008,23(8):669-670.
[16]楚戈,卡哈尔·艾肯木,何祖胜.单、双侧后外侧椎弓根钉置入并植骨融合治疗退变性腰椎滑脱的随机对照[J].中国组织工程研究与临床康复,2011,15(35):6540-6545.
[17]Lowe TG,Tahernia AD,O'Brien MF,et al.Unilateral transforaminal posterior lumbar interbody fusion(TLIF):indications,technique,and 2-year results.J Spinal Disord Tech.2002;15(1):31-38.
[18]Ozgur BM,Aryan HE,Pimenta L,et al.Extreme Lateral Interbody Fusion(XLIF):a novel surgical technique for anterior lumbar interbody fusion.Spine J.2006;6(4):435-443.
[19]Lehmer SM,Steffee AD,Gaines RJ.Treatment of L5-S1spondyloptosis by staged L5 resection with reduction and fusion of L4 onto S1(Gaines procedure).Spine(Phila Pa 1976).1994;19(17):1916-1925.
[20]Rodgers WB,Gerber EJ,Patterson J.Intraoperative and early postoperative complications in extreme lateral interbody fusion:an analysis of 600 cases.Spine(Phila Pa 1976).2011;36(1):26-32.
[21]La Rosa G,Conti A,Cacciola F,et al.Pedicle screw fixation for isthmic spondylolisthesis:does posterior lumbar interbody fusion improve outcome over posterolateral fusion?J Neurosurg.2003;99(2 Suppl):143-150.
[22]Helenius I,Lamberg T,Osterman K,et al.Posterolateral,anterior,or circumferential fusion in situ for high-grade spondylolisthesis in young patients:a long-term evaluation using the Scoliosis Research Society questionnaire.Spine(Phila Pa 1976).2006;31(2):190-196.
[23]Kwon BK,Hilibrand AS,Malloy K,et al.A critical analysis of the literature regarding surgical approach and outcome for adult low-grade isthmic spondylolisthesis.J Spinal Disord Tech.2005;18 Suppl:S30-S40.
[24]Lundin DA,Wiseman D,Ellenbogen RG,et al.Direct repair of the pars interarticularis for spondylolysis and spondylolisthesis.Pediatr Neurosurg.2003;39(4):195-200.
[25]Ivanic GM,Pink TP,Achatz W,et al.Direct stabilization of lumbar spondylolysis with a hook screw:mean 11-year follow-up period for 113 patients.Spine(Phila Pa 1976).2003;28(3):255-259.
[26]Gaines RW.L5 vertebrectomy for the surgical treatment of spondyloptosis:thirty cases in 25 years.Spine(Phila Pa 1976).2005;30(6 Suppl):S66-S70.
[27]Wild A,Jager M,Werner A,et al.Treatment of congenital spondyloptosis in an 18-month-old patient with a 10-year follow-up.Spine(Phila Pa 1976).2001;26(21):E502-E505.
[28]邹德威,海涌,马华松,等.重度腰椎滑脱的治疗[J].中华骨科杂志,1998,18(5):4-7.
[29]Kim DY,Lee SH,Chung SK,et al.Comparison of multifidus muscle atrophy and trunk extension muscle strength:percutaneous versus open pedicle screw fixation.Spine(Phila Pa1976).2005;30(1):123-129.
[30]Wu RH,Fraser JF,Hartl R.Minimal access versus open transforaminal lumbar interbody fusion:meta-analysis of fusion rates.Spine(Phila Pa 1976).2010;35(26):2273-2281.
[31]Tsutsumimoto T,Shimogata M,Ohta H,et al.Mini-open versus conventional open posterior lumbar interbody fusion for the treatment of lumbar degenerative spondylolisthesis:comparison of paraspinal muscle damage and slip reduction.Spine(Phila Pa1976).2009;34(18):1923-1928.
[32]Mihara H,Onari K,Cheng BC,et al.The biomechanical effects of spondylolysis and its treatment.Spine(Phila Pa 1976).2003;28(3):235-238.
[33]郑应,谭明生.腰椎后路非融合固定系统的临床应用[J].中国骨伤,2007,20(4):283-285.
[34]Agabegi SS,Fischgrund JS.Contemporary management of isthmic spondylolisthesis:pediatric and adult.Spine J.2010;10(6):530-543.
[35]Jacobs WC,Vreeling A,De Kleuver M.Fusion for low-grade adult isthmic spondylolisthesis:a systematic review of the literature.Eur Spine J.2006;15(4):391-402.
[36]Ohtori S,Koshi T,Yamashita M,et al.Single-level instrumented posterolateral fusion versus non-instrumented anterior interbody fusion for lumbar spondylolisthesis:a prospective study with a2-year follow-up.J Orthop Sci.2011;16(4):352-358.
[37]Musluman AM,Yilmaz A,Cansever T,et al.Posterior lumbar interbody fusion versus posterolateral fusion with instrumentation in the treatment of low-grade isthmic spondylolisthesis:midterm clinical outcomes.J Neurosurg Spine.2011;14(4):488-496.
[38]Zhou ZJ,Zhao FD,Fang XQ,et al.Meta-analysis of instrumented posterior interbody fusion versus instrumented posterolateral fusion in the lumbar spine.J Neurosurg Spine.2011;15(3):295-310.
[39]Humphreys SC,Hodges SD,Patwardhan AG,et al.Comparison of posterior and transforaminal approaches to lumbar interbody fusion.Spine(Phila Pa 1976).2001;26(5):567-571.
[40]Kim KT,Lee SH,Lee YH,et al.Clinical outcomes of 3 fusion methods through the posterior approach in the lumbar spine.Spine(Phila Pa 1976).2006;31(12):1351-1357,1358.
[41]Min JH,Jang JS,Lee SH.Comparison of anterior-and posterior-approach instrumented lumbar interbody fusion for spondylolisthesis.J Neurosurg Spine.2007;7(1):21-26.
[42]Hsieh PC,Koski TR,O'Shaughnessy BA,et al.Anterior lumbar interbody fusion in comparison with transforaminal lumbar interbody fusion:implications for the restoration of foraminal height,local disc angle,lumbar lordosis,and sagittal balance.JNeurosurg Spine.2007;7(4):379-386.
[43]Kim JS,Kang BU,Lee SH,et al.Mini-transforaminal lumbar interbody fusion versus anterior lumbar interbody fusion augmented by percutaneous pedicle screw fixation:a comparison of surgical outcomes in adult low-grade isthmic spondylolisthesis.J Spinal Disord Tech.2009;22(2):114-121.
[44]Kim JS,Lee KY,Lee SH,et al.Which lumbar interbody fusion technique is better in terms of level for the treatment of unstable isthmic spondylolisthesis?J Neurosurg Spine.2010;12(2):171-177.
[45]Yan DL,Pei FX,Li J,et al.Comparative study of PILF and TLIFtreatment in adult degenerative spondylolisthesis.Eur Spine J.2008;17(10):1311-1316.
[46]Goz V,Weinreb JH,Schwab F,et al.Comparison of complications,costs,and length of stay of three different lumbar interbody fusion techniques:an analysis of the Nationwide Inpatient Sample database.Spine J.2014;14(9):2019-2027.
[47]Kwon BK,Albert TJ.Adult low-grade acquired spondylolytic spondylolisthesis:evaluation and management.Spine(Phila Pa1976).2005;30(6 Suppl):S35-S41.
[48]Hakalo J,Wronski J.The role of reduction in operative treatment of spondylolytic spondylolisthesis.Neurol Neurochir Pol.2008;42(4):345-352.
[49]Soegaard R,Bunger CE,Christiansen T,et al.Circumferential fusion is dominant over posterolateral fusion in a long-term perspective:cost-utility evaluation of a randomized controlled trial in severe,chronic low back pain.Spine(Phila Pa 1976).2007;32(22):2405-2414.
[50]Videbaek TS,Christensen FB,Soegaard R,et al.Circumferential fusion improves outcome in comparison with instrumented posterolateral fusion:long-term results of a randomized clinical trial.Spine(Phila Pa 1976).2006;31(25):2875-2880.
[51]Remes V,Lamberg T,Tervahartiala P,et al.Long-term outcome after posterolateral,anterior,and circumferential fusion for high-grade isthmic spondylolisthesis in children and adolescents:magnetic resonance imaging findings after average of 17-year follow-up.Spine(Phila Pa 1976).2006;31(21):2491-2499.
[52]Swan J,Hurwitz E,Malek F,et al.Surgical treatment for unstable low-grade isthmic spondylolisthesis in adults:a prospective controlled study of posterior instrumented fusion compared with combined anterior-posterior fusion.Spine J.2006;6(6):606-614.
[53]Kim JS,Kim DH,Lee SH,et al.Comparison study of the instrumented circumferential fusion with instrumented anterior lumbar interbody fusion as a surgical procedure for adult low-grade isthmic spondylolisthesis.World Neurosurg.2010;73(5):565-571.
[2]Pankowski R,Smoczynski A,Roclawski M,et al.Operative treatment of isthmic spondylolisthesis with posterior stabilization and ALIF.Cages versus autogenous bone grafts.Stud Health Technol Inform.2012;176:311-314.
[3]潘良春,黄彰,江华.腰椎滑脱症的治疗进展[J].创伤外科杂志,2009,11(3):278-280.
[4]西永明,贾连顺.退行性腰椎滑脱外科治疗中的相关问题[J].中国脊柱脊髓杂志,2006,16(1):65-67.
[5]Sengupta DK,Herkowitz HN.Degenerative spondylolisthesis:review of current trends and controversies.Spine(Phila Pa 1976).2005;30(6 Suppl):S71-S81.
[6]阮狄克,何勍,丁宇,等.单纯减压治疗伴Ⅰ度退变滑脱的腰椎管狭窄症的中远期疗效分析[J].中国脊柱脊髓杂志,2006,16(1):11-14.
[7]Johnsson R,Stromqvist B,Axelsson P,et al.Influence of spinal immobilization on consolidation of posterolateral lumbosacral fusion.A roentgen stereophotogrammetric and radiographic analysis.Spine(Phila Pa 1976).1992;17(1):16-21.
[8]Sairyo K,Katoh S,Sakamaki T,et al.Vertebral forward slippage in immature lumbar spine occurs following epiphyseal separation and its occurrence is unrelated to disc degeneration:is the pediatric spondylolisthesis a physis stress fracture of vertebral body?Spine(Phila Pa 1976).2004;29(5):524-527.
[9]Kanamori M,Yasuda T,Hori T,et al.Minimum 10-year follow-up study of anterior lumbar interbody fusion for degenerative spondylolisthesis:progressive pattern of the adjacent disc degeneration.Asian Spine J.2012;6(2):105-114.
[10]Inoue S,Watanabe T,Goto S,et al.Degenerative spondylolisthesis.Pathophysiology and results of anterior interbody fusion.Clin Orthop Relat Res.1988;227:90-98.
[11]陈守来,陈浩,陈明江,等.经前路椎体间植骨融合治疗腰椎滑脱[J].中国矫形外科杂志,2000,7(7):79-80.
[12]王慧敏,谭明生,李子荣,等.椎体间融合器治疗腰椎滑脱症[J].中国矫形外科杂志,2003,11(Z1):47-49.
[13]楚戈,白靖平,锡林·宝勒日,等.退变性腰椎滑脱的治疗进展[J].中国矫形外科杂志,2007,15(19):1486-1488.
[14]Klockner C,Weber U.Correction of lumbosacral kyphosis in high grade spondylolisthesis and spondyloptosis.Orthopade.2001;30(12):983-987.
[15]王建顺,王新虎,刘继军,等.椎弓根螺钉内固定结合椎体间植骨术治疗腰椎滑脱症的疗效观察[J].中国骨与关节损伤杂志,2008,23(8):669-670.
[16]楚戈,卡哈尔·艾肯木,何祖胜.单、双侧后外侧椎弓根钉置入并植骨融合治疗退变性腰椎滑脱的随机对照[J].中国组织工程研究与临床康复,2011,15(35):6540-6545.
[17]Lowe TG,Tahernia AD,O'Brien MF,et al.Unilateral transforaminal posterior lumbar interbody fusion(TLIF):indications,technique,and 2-year results.J Spinal Disord Tech.2002;15(1):31-38.
[18]Ozgur BM,Aryan HE,Pimenta L,et al.Extreme Lateral Interbody Fusion(XLIF):a novel surgical technique for anterior lumbar interbody fusion.Spine J.2006;6(4):435-443.
[19]Lehmer SM,Steffee AD,Gaines RJ.Treatment of L5-S1spondyloptosis by staged L5 resection with reduction and fusion of L4 onto S1(Gaines procedure).Spine(Phila Pa 1976).1994;19(17):1916-1925.
[20]Rodgers WB,Gerber EJ,Patterson J.Intraoperative and early postoperative complications in extreme lateral interbody fusion:an analysis of 600 cases.Spine(Phila Pa 1976).2011;36(1):26-32.
[21]La Rosa G,Conti A,Cacciola F,et al.Pedicle screw fixation for isthmic spondylolisthesis:does posterior lumbar interbody fusion improve outcome over posterolateral fusion?J Neurosurg.2003;99(2 Suppl):143-150.
[22]Helenius I,Lamberg T,Osterman K,et al.Posterolateral,anterior,or circumferential fusion in situ for high-grade spondylolisthesis in young patients:a long-term evaluation using the Scoliosis Research Society questionnaire.Spine(Phila Pa 1976).2006;31(2):190-196.
[23]Kwon BK,Hilibrand AS,Malloy K,et al.A critical analysis of the literature regarding surgical approach and outcome for adult low-grade isthmic spondylolisthesis.J Spinal Disord Tech.2005;18 Suppl:S30-S40.
[24]Lundin DA,Wiseman D,Ellenbogen RG,et al.Direct repair of the pars interarticularis for spondylolysis and spondylolisthesis.Pediatr Neurosurg.2003;39(4):195-200.
[25]Ivanic GM,Pink TP,Achatz W,et al.Direct stabilization of lumbar spondylolysis with a hook screw:mean 11-year follow-up period for 113 patients.Spine(Phila Pa 1976).2003;28(3):255-259.
[26]Gaines RW.L5 vertebrectomy for the surgical treatment of spondyloptosis:thirty cases in 25 years.Spine(Phila Pa 1976).2005;30(6 Suppl):S66-S70.
[27]Wild A,Jager M,Werner A,et al.Treatment of congenital spondyloptosis in an 18-month-old patient with a 10-year follow-up.Spine(Phila Pa 1976).2001;26(21):E502-E505.
[28]邹德威,海涌,马华松,等.重度腰椎滑脱的治疗[J].中华骨科杂志,1998,18(5):4-7.
[29]Kim DY,Lee SH,Chung SK,et al.Comparison of multifidus muscle atrophy and trunk extension muscle strength:percutaneous versus open pedicle screw fixation.Spine(Phila Pa1976).2005;30(1):123-129.
[30]Wu RH,Fraser JF,Hartl R.Minimal access versus open transforaminal lumbar interbody fusion:meta-analysis of fusion rates.Spine(Phila Pa 1976).2010;35(26):2273-2281.
[31]Tsutsumimoto T,Shimogata M,Ohta H,et al.Mini-open versus conventional open posterior lumbar interbody fusion for the treatment of lumbar degenerative spondylolisthesis:comparison of paraspinal muscle damage and slip reduction.Spine(Phila Pa1976).2009;34(18):1923-1928.
[32]Mihara H,Onari K,Cheng BC,et al.The biomechanical effects of spondylolysis and its treatment.Spine(Phila Pa 1976).2003;28(3):235-238.
[33]郑应,谭明生.腰椎后路非融合固定系统的临床应用[J].中国骨伤,2007,20(4):283-285.
[34]Agabegi SS,Fischgrund JS.Contemporary management of isthmic spondylolisthesis:pediatric and adult.Spine J.2010;10(6):530-543.
[35]Jacobs WC,Vreeling A,De Kleuver M.Fusion for low-grade adult isthmic spondylolisthesis:a systematic review of the literature.Eur Spine J.2006;15(4):391-402.
[36]Ohtori S,Koshi T,Yamashita M,et al.Single-level instrumented posterolateral fusion versus non-instrumented anterior interbody fusion for lumbar spondylolisthesis:a prospective study with a2-year follow-up.J Orthop Sci.2011;16(4):352-358.
[37]Musluman AM,Yilmaz A,Cansever T,et al.Posterior lumbar interbody fusion versus posterolateral fusion with instrumentation in the treatment of low-grade isthmic spondylolisthesis:midterm clinical outcomes.J Neurosurg Spine.2011;14(4):488-496.
[38]Zhou ZJ,Zhao FD,Fang XQ,et al.Meta-analysis of instrumented posterior interbody fusion versus instrumented posterolateral fusion in the lumbar spine.J Neurosurg Spine.2011;15(3):295-310.
[39]Humphreys SC,Hodges SD,Patwardhan AG,et al.Comparison of posterior and transforaminal approaches to lumbar interbody fusion.Spine(Phila Pa 1976).2001;26(5):567-571.
[40]Kim KT,Lee SH,Lee YH,et al.Clinical outcomes of 3 fusion methods through the posterior approach in the lumbar spine.Spine(Phila Pa 1976).2006;31(12):1351-1357,1358.
[41]Min JH,Jang JS,Lee SH.Comparison of anterior-and posterior-approach instrumented lumbar interbody fusion for spondylolisthesis.J Neurosurg Spine.2007;7(1):21-26.
[42]Hsieh PC,Koski TR,O'Shaughnessy BA,et al.Anterior lumbar interbody fusion in comparison with transforaminal lumbar interbody fusion:implications for the restoration of foraminal height,local disc angle,lumbar lordosis,and sagittal balance.JNeurosurg Spine.2007;7(4):379-386.
[43]Kim JS,Kang BU,Lee SH,et al.Mini-transforaminal lumbar interbody fusion versus anterior lumbar interbody fusion augmented by percutaneous pedicle screw fixation:a comparison of surgical outcomes in adult low-grade isthmic spondylolisthesis.J Spinal Disord Tech.2009;22(2):114-121.
[44]Kim JS,Lee KY,Lee SH,et al.Which lumbar interbody fusion technique is better in terms of level for the treatment of unstable isthmic spondylolisthesis?J Neurosurg Spine.2010;12(2):171-177.
[45]Yan DL,Pei FX,Li J,et al.Comparative study of PILF and TLIFtreatment in adult degenerative spondylolisthesis.Eur Spine J.2008;17(10):1311-1316.
[46]Goz V,Weinreb JH,Schwab F,et al.Comparison of complications,costs,and length of stay of three different lumbar interbody fusion techniques:an analysis of the Nationwide Inpatient Sample database.Spine J.2014;14(9):2019-2027.
[47]Kwon BK,Albert TJ.Adult low-grade acquired spondylolytic spondylolisthesis:evaluation and management.Spine(Phila Pa1976).2005;30(6 Suppl):S35-S41.
[48]Hakalo J,Wronski J.The role of reduction in operative treatment of spondylolytic spondylolisthesis.Neurol Neurochir Pol.2008;42(4):345-352.
[49]Soegaard R,Bunger CE,Christiansen T,et al.Circumferential fusion is dominant over posterolateral fusion in a long-term perspective:cost-utility evaluation of a randomized controlled trial in severe,chronic low back pain.Spine(Phila Pa 1976).2007;32(22):2405-2414.
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