title: Normal Health-Related Quality of Life and Ability to Work Twenty-nine Years After in Situ Arthrodesis for High-Grade Isthmic Spondylolisthesis.
abstract: BACKGROUND
  The purpose of this mixed prospective and retrospective case series was to evaluate the long-term health-related quality of life and physical disability after in situ arthrodesis for high-grade isthmic spondylolisthesis.
  
  
  METHODS
  Thirty-five of forty consecutive patients who had in situ spinal arthrodesis for high-grade isthmic spondylolisthesis at a mean age of fifteen years (range, nine to twenty-five years) completed validated questionnaires (Short Form-36 [SF-36], EuroQol-5 Dimensions [EQ-5D], Zung depression scale, Oswestry disability index [ODI], Million score, and back and leg pain visual analog scale [VAS]) and underwent physical examination twenty-nine years (range, twenty-three to thirty-five years) after surgery. The mean age at the time of follow-up was forty-three years (range, thirty-seven to fifty-one years). In the absence of a formal control group, the scores on the SF-36 and EQ-5D were compared with Swedish normative data. The proportion of patients at work was compared with an age-matched control group derived from official statistics of Sweden. The Million score at the long-term follow-up was compared with the corresponding results at the mid-term follow-up of the same patients at a mean age of twenty-two years.
  
  
  RESULTS
  The scores on the SF-36 and EQ-5D were similar to the scores of the general Swedish population. The mean Zung depression scale score was 30 (range, 20 to 52), the mean ODI score was 10 (range, 0 to 34), the mean back pain VAS score was 13 (range, 0 to 72), and the mean leg pain VAS score was 9 (range, 0 to 60). The Million score averaged 28 (range, 0 to 109) and was slightly worsened compared with the score of 19 (range, 0 to 94) at the mid-term follow-up (p = 0.034). The proportion of patients at work was the same as that for the age-matched general Swedish population.
  
  
  CONCLUSIONS
  Our study shows good outcomes in health-related quality of life, disability, pain, and ability to work at up to twenty-nine years after in situ lumbar spine arthrodesis for high-grade isthmic spondylolisthesis.
  
  
  METHODS
  Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
authors.affiliation: Department of Orthopaedic Surgery, Orebro University Hospital, SE-701 85 Orebro, Sweden. E-mail address: anders@joelson.se.
authors.forename: Anders
authors.initials: A
authors.lastname: Joelson
authors.affiliation: Department of Orthopaedics, Sahlgrenska University Hospital, SE-413 45 Gothenburg, Sweden.
authors.forename: Rune
authors.initials: R
authors.lastname: Hedlund
authors.affiliation: Department of Orthopaedics, Sahlgrenska University Hospital, SE-413 45 Gothenburg, Sweden.
authors.forename: Karin
authors.initials: K
authors.lastname: Frennered
mesh_terms: D000293:Adolescent; D000328:Adult; D001174:Arthrodesis / Q000379:methods*; D002648:Child; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D010147:Pain Measurement; D011446:Prospective Studies; D011788:Quality of Life; D012189:Retrospective Studies; D062707:Return to Work; D013168:Spondylolisthesis / Q000601:surgery*; D011795:Surveys and Questionnaires; D013548:Sweden; D016896:Treatment Outcome