Details

Autor(en) / Beteiligte

• Toobaie, Asra
• Urquhart, Jennifer
• Thornley, Patrick
• Rasoulinejad, Parham
• Glennie, Andrew
• Rampersaud, Raja
• Manson, Neil
• Abraham, Edward
• Fisher, Charles
• Charest-Morin, Raphaele
• Paquette, Scott
• Gélinas-Phaneuf, Nicholas
• Thomas, Ken
• Dea, Nicholas
• Dvorak, Marcel
• Kwon, Brian
• Street, John
• Ailon, Tamir
• Christie, Sean
• Bailey, Chris

Titel

Posterolateral versus posterior interbody fusion for the management of lumbar degenerative spondylolisthesis: analysis from the CSORN prospective LDS propensity score matched study

Ist Teil von

• Canadian Journal of Surgery, 2022-12, Vol.65, p.S120-S121

Ort / Verlag

Ottawa: CMA Impact, Inc

Erscheinungsjahr

2022

Quelle

EZB Electronic Journals Library

Beschreibungen/Notizen

• Background: The benefit of interbody fusion (IF) over posterolateral fusion in the treatment of spondylolisthesis is controversial. Little evidence focuses on the treatment of degenerative spondylolisthesis. The objective of this study was to compare postoperative patient-rated outcomes (PROs) of posterolateral fusion (PLF) versus IF surgery in patients with lumbar degenerative spondylolisthesis. Methods: This is a retrospective analysis of data from a Canadian Spine Outcomes and Research Network (CSORN) multicentre prospective study on the assessment and management of patients with lumbar degenerative spondylolisthesis (LDS). Inclusion criteria included: LDS at 1 or 2 levels, age 18 years or older, IF or PLF surgery, and minimum 1 year follow-up after surgery. Propensity-score matching was used to match similar cohorts of patients who underwent IF and PLF on the basis of baseline patient characteristics including sex, age, primary symptom type (radiculopathy v. claudication back pain), body mass index, SF-12 mental component score (MCS), spondylolisthesis grade, disc angle (lordotic v. kyphotic/neutral), smoking status, levels fused, back pain and presence of neurologic deficit (motor or sensory). Patient-reported outcomes including numeric rating scale (NRS) back pain, NRS leg pain, Oswestry Disability Index (ODI), and SF-12 MCS and physical component score (PCS) were compared over time using repeated-measures mixed-effects modelling. Results: Eight centres participated in the study from January 2015 to September 2020. Of the 567 enrolled patients, 278 (56 with PLF, 222 with IF) met the inclusion criteria. After propensity score matching, 48 patients were included in each group. The follow-up rate was 80% at 1 year. Study participants mostly were female and had grade I spondylolisthesis in a single level, neurogenic claudication and symptom duration greater than 2 years. At 3 and 12 months there were no significant differences in the intensity of back pain, leg pain or ODI, MCS or PCS scores between the PLF and IF groups. Operation time, blood loss, adverse events and length of stay were equal between the groups. Conclusion: Our study found equivalence in patient-reported outcomes between PLF and IF in propensity-matched patients with degenerative spondylolisthesis at 12 months. Longer term follow-up and focused investigation are required to determine if specific indications exist for IF in the management of degenerative spondylolisthesis.