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Can J Surg. 2014 Aug;57(4):E126-33.

Health-related quality of life following decompression compared to decompression and fusion for degenerative lumbar spondylolisthesis: a Canadian multicentre study.

Author information

1
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.
2
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.
3
The Sunnybrook Health Sciences Centre, Toronto, Ont.
4
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.
5
The Atlantic Health Science Corporation, St. John, NB.
6
The Dalhousie University, QEII Health Sciences Centre, Halifax, NS.

Abstract

in English, French

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.

CONCLUSION:

In select patients with DLS, the outcome of D is comparable to DF at a minimum of 2 years.

PMID:
25078938
PMCID:
PMC4119126
DOI:
10.1503/cjs.032213
[Indexed for MEDLINE]
Free PMC Article

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