spinal fusion

Spinal fusion is used for the surgical treatment of spondylolisthesis in children. Children with spondylolisthesis are displaced forward or backward by the vertebral arch due to rupture of the vertebral arch. The forward shifter is called the anterior spine slip; even if the shift is backward, it is called posterior spine slip; if there is no shift, the pedicle is cracked. The cause of the disease is thought to be related to factors such as congenital lamina isthral defect, trauma and isthmus developmental disorders. Children with spondylolisthesis occur mostly after the age of 10 and are most common at 14 years old. When the spine is slipped, it can often directly compress the spinal nerves or cause disc herniation, muscle spasm and ligament damage. It occurs in L5, which accounts for about 90%, sometimes in L3 to L4, and occasionally in C5 to C6. Lumbar spine slippery manifestations of trunk shortening, lumbar lordosis increased significantly, may have low back pain, severe cases may occur sciatica, skin sensory disturbances, limited bending activities, straight leg elevation test positive, knee and Achilles tendon The reflection is weakened or disappeared, and even the incontinence is incontinent, and the lower limbs are incomplete. Occurred in the cervical spine may have neck pain, muscle spasm, torticollis, restricted neck activity, and even difficulty swallowing. According to the X-ray film, according to the severity of the upper vertebral body relative to the lower vertebral body slip, the spondylolisthesis can be divided into I, II, III, IV, V degrees. The I degree slippery vertebral body is displaced forward to less than 25% of the anteroposterior diameter of the lower vertebral body, the second degree is 25% to 50%, the third degree is 50% to 75%, the IV degree is >75%, and the V degree is (the spine). Advance shift) is the complete separation of the superior vertebral body from the lower vertebral body. In the choice of treatment, for those who are not obvious, and the X-ray film is only shifted by one degree, non-surgical treatment is adopted, including restricting patient activity, back muscle massage, traction and brace fixation therapy. About 20% of patients with symptomatic spondylolisthesis need surgery. For patients with painful spondylolisthesis, the younger the patient, the more certain the indications for surgery and the better the surgical outcome. Sciatica is often the cause of surgical treatment in this type of patient. Spinal fusion, spinal fusion, internal fixation plus spinal fusion can be used according to different conditions. Treatment of diseases: lumbar spondylolisthesis, isthmus, and spondylolisthesis Indication Spinal fusion is suitable for: 1. The spine is severely slippery. 2, the performance of nerve damage. Contraindications 1. The general condition is poor and there are important organ diseases. 2. There are infected lesions in the skin near the surgical area. Preoperative preparation 1. The full lateral spine of the spine determines the degree and extent of spondylolisthesis. 2. Electrophysiological examination. 3, blood chemical examination. 4. Application of antibiotics. Surgical procedure Stage I surgery: the anterior portion of the lumbosacral vertebral body is exposed through the peritoneal or extraperitoneal approach, and the L5 vertebral body, L4~5 and L5~S1 intervertebral discs are removed until the base of the L5 pedicle. Stage II: The posterior median approach was performed to remove the loose vertebral arch and L5 pedicle. The opposite end plates of L4 and S1 were treated to facilitate fusion. The L4 vertebral body was reattached to the S1 vertebral body (with or without interbody fusion), and the pedicle instrument was used to maintain the fusion and fusion of L4 and S1, while conventional bilateral posterolateral fusion was performed. complication 1, abdominal cavity, pelvic organ damage, sputum total motion, venous injury. 2. Damage to the cauda equina and nerve roots. 3, bone graft fusion failed, pseudo joint formation.