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Effect of Modified Assisted Reduction and Internal Fixation System on Chronic Pain and Long-term Prognosis After
Nan Jia1, Zhao Wang2, Pengfei Li2,3,4
1Department of Surgery, Harrison International Peace Hospital, Hengshui, China.
Background:
This study prospectively investigated the clinical significance of the modified assisted reduction and internal fixation system in relieving chronic pain following isthmic spondylolisthesis surgery.
Methods:
In total, 58 patients with isthmic spondylolisthesis were randomly divided into the observation group and control group. Twenty-eight patients belonged to the observation group (application of modified assisted reduction and internal fixation system) and 30 patients belonged to the control group (application of traditional posterior reduction and internal fixation system). All patients received regular postoperative rehabilitation treatment. The pre- and postoperative degree of spondylolisthesis and intervertebral height were compared between the 2 groups. Visual analog scale and Oswestry Disability Index scores for each patient were collected. The rates of fusion and implant-related complications were also assessed.
Results:
Baseline characteristics and operation conditions of the 2 groups were similar. There was no significant difference between the 2 groups in the mean visual analog scale scores for low back pain (2.1 vs 2.8, P > 0.05, |d| = 0.38) and radicular symptoms (1.7 vs 2.0, P > 0.05, |d| = 0.38) or Oswestry Disability Index scores (18.6% vs 22.5%, P > 0.05, |d| = 0.38) at 12 months, Cohen's d effect size analysis indicated small effects for all. Among various radiological measurement indicators, the observation group performed better than the control group, with statistically significant differences in the mean height of intervertebral space (11.4 vs 10.0, P < 0.05) and the mean degree of spondylolisthesis (9.6 vs 18.4, P < 0.05) observed at 12 months. During the 12-month follow-up, the fusion rate of the control group was 76.7%, and that of the observation group was 85.7% (P > 0.05). The observation group did not report any implant-related complications, whereas the control group identified 1 case of pedicle screw loosening and 1 case of pedicle screw fracture, leading to a total complication rate of 6.67% (P < 0.05).
Conclusion:
The modified assisted reduction and internal fixation system has clinical value in alleviating postoperative chronic pain and improving long-term prognosis in patients with isthmic spondylolisthesis.
Clinical Relevance:
This modified treatment method can effectively enhance the surgical outcomes for patients with isthmic spondylolisthesis.

