Prospective study of surgical treatment of degenerative spondylolisthesis: comparison between decompression alone and decompression with graf system stabilization.
METHODS
A prospective study of patients with degenerative spondylolisthesis who underwent decompression of the spine, with and without stabilization using the Graf system.


OBJECTIVE
To assess the clinical result of decompression alone and decompression using the Graf system.


BACKGROUND
The clinical outcome of lumbar stabilization for degenerative spondylolisthesis remains uncertain. There is no prospective study of differences in clinical outcome between patients who undergo decompression alone and those who undergo decompression and stabilization using the Graf system.


METHODS
Eighty-eight patients with degenerative spondylolisthesis were included in this study. All patients reported leg symptoms. Decompression alone (Group D) was performed in 42 patients during a 5-year period from 1988 through 1992. Decompression and stabilization with the Graf system (Group G) was performed in 46 patients during a 4-year period from 1993 through 1996. There was no statistical difference regarding sex, the age at operation, compensable cases, and preoperative duration between two groups. The two groups were evaluated at follow-up examinations 1 and 3 years after surgery. The clinical results were evaluated for all patients by means of a 4-grade scale, visual analog scale, recurrence of leg symptoms, and persistent low back pain. The radiographic and clinical findings were examined by an independent investigator.


RESULTS
The results according to the 4-grade scale deteriorated with time in both groups. There was no statistical difference between the two groups in the 4-grade scale, visual analog scale, or recurrence of leg symptoms at each follow-up time. Persistent low back pain in Group G was significantly lower than that in Group D at both the 1- and 3-year follow-ups.


CONCLUSIONS
Although lumbar Graf stabilization had no effect in preventing the recurrence of leg symptoms, there was a significant effect on reduction of low back pain at the 1- and 3-year follow-ups.
Konno
S
S
Department of Orthopedic Surgery, Fukushima Medical University, Japan.
Kikuchi
S
S
D000328:Adult; D000368:Aged; D001863:Bone Screws; D019299:Decompression, Surgical; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007593:Joint Instability / Q000000981:diagnostic imaging / Q000601:surgery; D007866:Leg; D017116:Low Back Pain / Q000000981:diagnostic imaging / Q000601:surgery; D008297:Male; D009068:Movement; D011183:Postoperative Complications; D011446:Prospective Studies; D011859:Radiography; D012008:Recurrence; D013130:Spinal Stenosis / Q000000981:diagnostic imaging / Q000601:surgery; D013168:Spondylolisthesis / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome