Details

Autor(en) / Beteiligte

• Thornley, Patrick
• Urquhart, Jennifer
• Rampersaud, Raja
• Glennie, Andrew
• Fisher, Charles
• Bailey, Chris

Titel

A CSORN study of functional outcomes after surgery for lumbar degenerative spondylolisthesis

Ist Teil von

• Canadian Journal of Surgery, 2022-12, Vol.65, p.S158-S158

Ort / Verlag

Ottawa: CMA Impact, Inc

Erscheinungsjahr

2022

Quelle

EZB Electronic Journals Library

Beschreibungen/Notizen

• Background: The objective of this study was to identify the radiographic parameters that correlate with functional outcomes after degenerative lumbar spondylolisthesis (DLS) surgery. Methods: We performed a retrospective analysis of the cohort of consecutively enrolled patients in the Canadian Spine Outcomes and Research Network (CSORN) prospective study on the assessment and management of DLS. Patients underwent decompression in isolation or with posterolateral or interbody fusion. Patient-reported outcomes (PROs) were severity of leg and back pain on a 10-point numeric rating scale and the Oswestry Disability Index (ODI). Global and regional alignment was assessed via sagittal vertical axis (SVA), pelvic incidence (PI) and lumbar lordosis (LL). PROs and upright radiographs were obtained preoperatively and at 1 year postoperatively. Correlation between patient outcomes and radiographic parameters was assessed using multivariate linear regression adjusted for age, body mass index, sex and presence of preoperative depression using the Patient Health Questionnaire-9 (PHQ9) score. Results: A total of 363 patients were included. Two-hundred and forty-one patients were available for analysis at 1 year. Among participants, mean age was 66 years with 63% female and a primary surgical indication of neurogenic claudication in 78% of patients. Multiple linear regression with adjustment for covariates showed that as PI-LL increased (worsened), ODI (R2 0.160, p = 0.004), back pain (R2 0.154, p < 0.01) and leg pain (R2 0.004, p = 0.014) scores also increased (worsened) at 1 year. Reduction of LL was associated with a higher ODI (R2 0.150, p = 0.027), back pain (R2 0.116, p = 0.007) and leg pain (R2 0.031, p = 0.038) score at 1 year. Increasing change in SVA score from baseline to 1 year (worsening) was associated with a higher (worse) ODI (R2 0.195, p = 0.013), back pain (R2 0.109, p = 0.037) and leg pain score (R2 0.035, p = 0.024). Conclusion: Preoperative emphasis on regional and global spinal alignment parameters must be considered to optimize surgical procedure indication and functional outcome in lumbar degenerative spondylolisthesis treatment.