Journal Article

Health-related quality of life following decompression compared to decompression and fusion for degenerative lumbar spondylolisthesis: a Canadian multicentre study

Fisher, Charles, MD, MHSc, Alexander, David, MD, Dvorak, Marcel F., MD, Oxner, William, MD, Abraham, Edward, MD, Lewis, Stephen J., MD, MSc, Finkelstein, Joel, MD, MSc, Yee, Albert, MD, MSc, Wai, Eugene, MD, MSc, Rampersaud, Y. Raja, MD

2014

Overview

Background Decompression alone (D) is a well-accepted treatment for patients with lumbar spinal stenosis (LSS) causing neurogenic claudication; however, D is controversial in patients with LSS who have degenerative spondylolisthesis (DLS). Our goal was to compare the outcome of anatomy-preserving D with decompression and fusion (DF) for patients with grade I DLS. We compared patients with DLS who had elective primary 1–2 level spinal D at 1 centre with a cohort who had 1–2 level spinal DF at 5 other centres. Methods Patients followed for at least 2 years were included. Primary analysis included comparison of change in SF-36 physical component summary (PCS) scores and the proportion of patients achieving minimal clinically important difference (MCID) and substantial clinical benefit (SCB). Results There was no significant difference in baseline SF-36 scores between the groups. The average change in PCS score was 10.4 versus 11.4 ( p = 0.61) for the D and DF groups, respectively. Sixty-seven percent of the D group and 71% of the DF group attained MCID, while 64% of both D and DF groups attained SCB. There was no significant difference between D and DF for change in PCS score ( p = 0.74) or likelihood of reaching MCID ( p = 0.81) or SCB ( p = 0.85) after adjusting for other variables. Conclusion In select patients with DLS, the outcome of D is comparable to DF at a minimum of 2 years.

• Publisher: CMA Joule Inc,CMA Impact, Inc,Canadian Medical Association
• Subject: Aged / Canada / Care and treatment / Combined Modality Therapy / Comparative analysis / Decompression (Physiology) / Decompression, Surgical / Female / Follow-Up Studies / Humans / Linear Models / Logistic Models / Lumbar Vertebrae - surgery / Male / Medical disorders / Middle Aged / Multivariate Analysis / Online Research / Patient outcomes / Quality of life / Retrospective Studies / Spinal Fusion / Spondylolisthesis / Spondylolisthesis - surgery / Studies / Surgery / Treatment Outcome / Vertebrae