Types and efficiency of operations for spondylolisthesis
Surgical treatment of spondylolisthesis is aimed at stabilization of the injured segments of the spine and removing pressure from the strangulated spinal nerves. The intervention facilitates the human condition and improves physical activity.
Classification of surgical interventions
Surgery for spondylolisthesis involves the introduction of artificial fixatives to eliminate the mobility of the vertebrae.
Types of surgery for listesi:
- Lateral stabilization (spinal fusion).
In posterior spinal fusion access to the vertebral column is held with the back, front – through the anterior abdominal wall, lateral side of the abdomen.
widespread laparoscopic methods of surgical treatment of displacements of the vertebrae. They are associated with low invasiveness, which minimizes the risk of complications after the intervention.
A Thin probe with a camera in the terminal part is inserted into the spine through a small incision, which eliminates the damage to the ligaments, muscles and soft tissues. There has not been a great deal of bleeding, enabling the patient to go through rehabilitation and return to work.
Promising methods of surgical treatment
A Promising development is considered a front-access (extraperitoneal). It is a cut about the location of segments L4-L5 in the left iliac region 3 cm above the spine of the Ilium. The length of the incision is small – about 5 cm
In the next phase, the surgeon cuts through layers of soft tissue, the external oblique muscle and fascia. Access to the spine requires the crossing of the transverse muscles.
This area is exempt from segmental and major blood vessels. Subsequently exposing the left part of the fibrous ring of the intervertebral disc. The greater psoas muscle is not displaced in the direction of the in contrast to front and side accesses.
The Above procedure avoids traumatic injury of the sympathetic nerves of the lumbar plexus, which eliminates problems with small pelvis, in comparison with front access.
The next stage in the area of the damaged spinal segment is implemented protective retractor. It fixes the vertebral bodies and the intervertebral disc. The task of the device – protecting nerves and blood vessels together with the psoas muscle.
The Following steps are the most responsible in the implementation of extraperitoneal mini-access with spondylolisthesis. You need to shift in the direction of the iliac vein and release the Central portion of the disc, and a third of the body of the displaced vertebra.
The Location of the left iliac veins gives surgeons major difficulties, because in most cases it is necessary to shift by dissection of the anterior longitudinal ligament.
When the access to the vertebral body, the retractor shall be as follows, designed to protect from damage left iliac vein. It is also necessary to cover the junction between the iliac veins. For these purposes, is another retractor. It is located between the tooth body of the fifth lumbar vertebra (L5). The last retainer is installed to protect the peritoneum. Thus, surgeons form of operational access in the amount of 80h35 mm.
What implants are being used to eliminate displacement of the vertebrae
Popular implants surgical treatment of spondylolisthesis are:
- the Titanium implant used in conjunction with bone grafting
- Ventral plate with individual parameters;
- Hollow annular implant
- fix with screws.
Hollow annular implant provides a high density of fixation. When selected, you must meet the following conditions:
- Durable grip bone bed;
- Biological compatibility with tissues;
- Lack of toxicity
- less Traumatic installation technology.
In severe disease, the surgeons can set several types of implants at the same time. Thus, it is possible to prevent the likelihood of re-displacement of the vertebrae.
Surgical treatment of spondylolisthesis is low effectiveness of conservative methods of treatment. It shows the displacement of the vertebrae 3 and 4 degrees.