CLINICAL AND IMAGING FEATURES OF SURGICALLY TREATED LUMBAR SPONDYLOLISTHESIS

Tóm tắt

Background: Lumbar spondylolisthesis is a common cause of low back pain, reduced occupational capacity, impaired quality of life, and frequent recurrence. Without timely treatment, the disease may progress to spinal dysfunction, disability, and increased socioeconomic burden. Objectives: To describe the clinical and imaging characteristics and to evaluate the surgical treatment outcomes of lumbar spondylolisthesis treated with posterior lumbar interbody fusion (PLIF) using pedicle screws at Can Tho Central General Hospital. Materials and methods: A prospective descriptive study was conducted on 49 patients with lumbar spondylolisthesis treated with PLIF from July 2022 to April 2024. Clinical data, imaging findings, and treatment outcomes were collected and patients were followed up for 6 months. Results: The mean age of patients was 58.4 ± 10.4 years; females accounted for 67.3%. Mean BMI was 22.29 ± 2.79 and mean T-score was –2.42 ± 1.17; 73.5% of patients were diagnosed with osteoporosis. Imaging characteristics: Xray imaging showed that 93.9% of cases were grade I spondylolisthesis, most commonly at L4-L5 (63.2%). MRI findings revealed disc herniation in 85.7%, foraminal stenosis in 38.8%. Clinical characteristics: 95.9% had low back pain and 93.9% had radicular pain. Positive Straight Leg Raise test was observed in 91.8%, sensory disturbances in 95.9%, motor deficits in 20.4%, and muscle atrophy in 8.2%. The mean preoperative VAS scores were 6.49 for back pain and 6.22 for leg pain. Outcomes: At 6 months post-surgery, the mean VAS scores significantly decreased to 1.80 for back pain and 1.20 for leg pain (p < 0.001). PLIF surgery significantly improved clinical symptoms and functional outcomes. Conclusions: Lumbar spondylolisthesis predominantly affects middle-aged women, commonly presents as grade I at the L4-L5 level, and is associated with low back pain, radicular symptoms, and functional impairment. PLIF surgery significantly improves clinical symptoms, functional outcomes, and imaging findings after 6 months.