Comparison of the therapeutic effects of manual orthopedic manipulation and isthmus repair for lumbar spondylolysis

<b>Objective</b> Based on propensity score matching(PSM), the therapeutic effects of manual orthopedic manipulation and isthmus repair for lumbar spondylolysis were explored. <b>Methods</b> A retrospective analysis was conducted on the clinical data of 130 patients with lum...

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Main Author: LOU Hongda,FAN Yu,FENG Yu,WANG Ziyun,NA Jian
Format: Article
Language:zho
Published: The Editorial Department of Chinese Journal of Clinical Research 2025-07-01
Series:Zhongguo linchuang yanjiu
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Online Access:http://zglcyj.ijournals.cn/zglcyj/ch/reader/create_pdf.aspx?file_no=20250723
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Summary:<b>Objective</b> Based on propensity score matching(PSM), the therapeutic effects of manual orthopedic manipulation and isthmus repair for lumbar spondylolysis were explored. <b>Methods</b> A retrospective analysis was conducted on the clinical data of 130 patients with lumbar spondylolysis treated at the Air Force Special Medical Center from September 2019 to April 2023. Seventy patients treated with manual orthopedic manipulation were assigned to the orthopedic group,and 60 patients treated with isthmus repair were assigned to the repair group.PSM was used to match the general characteristics of the two groups,resulting in 45 pairs of patients with balanced covariates. The recovery conditions of the two groups were compared ,as well as the subjective symptom and sign scores of lumbar spondylolysis ,Visual Analogue Scale(VAS)scores,Oswestry Disability Index(ODI)scores and the occurrence of complications at different time points.<b>Results</b> After PSM,both groups showed favorable recovery outcomes. However,the treatment cost in the orthopedic group was lower than that in the repair group,while the hospitalization time in the repair group was shorter than that in the orthopedic group(<i>P</i><0.05). The subjective symptom and sign scores of lumbar spondylolysis in both groups at discharge were higher than that before treatment, and the scores in the orthopedic group were higher than that in the repair group(<i>P</i><0.05). After treatment,both groups showed reduced VAS and ODI scores compared to pre-treatment levels(<i>P</i><0.05). The orthopedic group had lower VAS and ODI scores at 1 month post-treatment,but higher ODI scores at 3 months post-treatment compared to the repair group(<i>P</i><0.05). During hospitalization ,the repair group had a higher incidence of postoperative complications than the orthopedic group(20.00% <i>vs</i> 4.44%,<i>χ</i><sup>2</sup>=5.075,<i>P</i><0.05). <b>Conclusion</b> Both manual orthopedic manipulation and isthmus repair are beneficial for patients with lumbar spondylolysis. Manual orthopedic manipulation has a lower costs and a better short-term recovery outcome ,while isthmus repair offers a shorter treatment cycle and better long-term prognosis.
ISSN:1674-8182