No difference in clinical outcome after posterolateral lumbar fusion between patients with isthmic spondylolisthesis and those with degenerative disc disease using pedicle screw instrumentation: a comparative study of 112 patients with 4 years of follow-up.
We compared the clinical outcome after spinal fusion between patients with isthmic spondylolisthesis and those with degenerative disc disease of the lumbar spine, using multiple logistic regression analysis. A questionnaire describing medication, pain, vocational status and patient satisfaction was mailed to all the patients at a median interval of 4 years after their operation. Fusion was evaluated on plain radiographs at a minimum of 12 months after surgery, and patients were classified as fused or not fused. The overall satisfaction rate was 70%. The results of the present study showed no difference in the outcome after spinal fusion between the two groups of patients. The factors that significantly increased the likelihood of an optimal result - defined as patient satisfaction, return to work, and reduced medication - were male gender, being in work prior to surgery, and being a non-smoker. Since spinal fusion is an expensive treatment with potentially serious risks, and leaves one-third of the patients with an unsatisfactory result, we believe that more studies focusing on the indications for surgery should be performed.
Gehrchen
P Martin
PM
Department of Orthopaedic Surgery U-2161, Spine Section, Rigshospitalet, the National University Hospital of Copenhagen, 2100 Copenhagen Ø, Denmark. martin@gehrchen.dk
Dahl
Benny
B
Katonis
Pavlos
P
Blyme
Peter
P
Tøndevold
Erik
E
Kiaer
Thomas
T
D000293:Adolescent; D000328:Adult; D000368:Aged; D001863:Bone Screws / Q000009:adverse effects / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000503:physiopathology / Q000523:psychology / Q000601:surgery*; D017116:Low Back Pain / Q000473:pathology / Q000523:psychology / Q000601:surgery; D008159:Lumbar Vertebrae / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D018579:Patient Selection; D011237:Predictive Value of Tests; D012086:Reoperation / Q000706:statistics & numerical data; D018582:Sick Leave; D013123:Spinal Fusion / Q000009:adverse effects / Q000523:psychology*; D013168:Spondylolisthesis / Q000503:physiopathology / Q000523:psychology / Q000601:surgery*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome