title: Health-related quality of life following decompression compared to decompression and fusion for degenerative lumbar spondylolisthesis: a Canadian multicentre study.
abstract: BACKGROUND
  Decompression alone (D) is a well-accepted treatment for patients with lumbar spinal stenosis (LSS) causing neurogenic claudication; however, D is controversial in patients with LSS who have degenerative spondylolisthesis (DLS). Our goal was to compare the outcome of anatomy-preserving D with decompression and fusion (DF) for patients with grade I DLS. We compared patients with DLS who had elective primary 1-2 level spinal D at 1 centre with a cohort who had 1-2 level spinal DF at 5 other centres.
  
  
  METHODS
  Patients followed for at least 2 years were included. Primary analysis included comparison of change in SF-36 physical component summary (PCS) scores and the proportion of patients achieving minimal clinically important difference (MCID) and substantial clinical benefit (SCB).
  
  
  RESULTS
  There was no significant difference in baseline SF-36 scores between the groups. The average change in PCS score was 10.4 versus 11.4 (p = 0.61) for the D and DF groups, respectively. Sixty-seven percent of the D group and 71% of the DF group attained MCID, while 64% of both D and DF groups attained SCB. There was no significant difference between D and DF for change in PCS score (p = 0.74) or likelihood of reaching MCID (p = 0.81) or SCB (p = 0.85) after adjusting for other variables.
  
  
  CONCLUSIONS
  In select patients with DLS, the outcome of D is comparable to DF at a minimum of 2 years.
authors: The Division of Orthopaedic Surgery, Department of Surgery, University of Toronto, and the Spinal Program, Krembil Neuroscience Center, Toronto Western Hospital University Health Network, University of Toronto, Toronto, Ont.
authors: Y Raja
authors: YR
authors: Rampersaud
authors: The Combined Neurosurgical and Orthopaedic Spine Program (CNOSP), Department of Orthopaedics, University of British Columbia, Vancouver Coastal Health Research Institute, Vancouver General Hospital, Vancouver, BC.
authors: Charles
authors: C
authors: Fisher
authors: The Sunnybrook Health Sciences Centre, Toronto, Ont.
authors: Albert
authors: A
authors: Yee
authors: The Combined Neurosurgical and Orthopaedic Spine Program (CNOSP), Department of Orthopaedics, University of British Columbia, Vancouver Coastal Health Research Institute, Vancouver General Hospital, Vancouver, BC.
authors: Marcel F
authors: MF
authors: Dvorak
authors: The Sunnybrook Health Sciences Centre, Toronto, Ont.
authors: Joel
authors: J
authors: Finkelstein
authors: The Division of Orthopaedic Surgery, Department of Surgery, University of Ottawa, The Ottawa Hospital, and the Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ont.
authors: Eugene
authors: E
authors: Wai
authors: The Atlantic Health Science Corporation, St. John, NB.
authors: Edward
authors: E
authors: Abraham
authors: The Division of Orthopaedic Surgery, Department of Surgery, University of Toronto, and the Spinal Program, Krembil Neuroscience Center, Toronto Western Hospital University Health Network, University of Toronto, Toronto, Ont.
authors: Stephen J
authors: SJ
authors: Lewis
authors: The Dalhousie University, QEII Health Sciences Centre, Halifax, NS.
authors: David
authors: D
authors: Alexander
authors: The Dalhousie University, QEII Health Sciences Centre, Halifax, NS.
authors: William
authors: W
authors: Oxner
mesh_terms: D000368:Aged; D002170:Canada; D003131:Combined Modality Therapy; D019299:Decompression, Surgical; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012189:Retrospective Studies; D013123:Spinal Fusion; D013168:Spondylolisthesis / Q000601:surgery*; D016896:Treatment Outcome