Patient-reported outcome of lumbar decompression with instrumented fusion for low-grade spondylolisthesis: influence of pathology and baseline symptoms.

Baseline Symptoms Degenerative spondylolisthesis Isthmic spondylolisthesis Patient rated outcome Spinal fusion

Journal

European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
ISSN: 1432-0932
Titre abrégé: Eur Spine J
Pays: Germany
ID NLM: 9301980

Informations de publication

Date de publication:
28 Aug 2024
Historique:
received: 02 10 2023
accepted: 19 07 2024
revised: 03 03 2024
medline: 28 8 2024
pubmed: 28 8 2024
entrez: 28 8 2024
Statut: aheadofprint

Résumé

Low-grade isthmic and degenerative spondylolisthesis (DS) of the lumbar spine are distinct pathologies but both can be treated with lumbar decompression with fusion. In a very large cohort, we compared patient-reported outcome in relation to the pathology and chief complaint at baseline. This was a retrospective analysis using the EUROSPINE Spine Tango Registry. We included 582 patients (age 60 ± 15 years; 65% female), divided into four groups based on two variables: type of spondylolisthesis and chief pain complaint (leg pain (LP) versus back pain). Patients completed the COMI preoperatively and up to 5 years follow-up (FU), and rated global treatment outcome (GTO). Regression models were used to predict COMI-scores at FU. Pain scores and satisfaction ratings were analysed. All patients experienced pronounced reductions in COMI scores. Relative to the other groups, the DS-LP group showed between 5% and 11% greater COMI score reduction (p < 0.01 up to 2 years' FU). This group also performed best with respect to pain outcomes and satisfaction. Long-term GTO was 93% at the 5 year FU, compared with between 82% and 86% in the other groups. Regardless of the type of spondylolisthesis, all groups experienced an improvement in COMI score after surgery. Patients with DS and LP as their chief complaint appear to benefit more than other patients. These results are the first to show that the type of the spondylolisthesis and its chief complaint have an impact on surgical outcome. They will be informative for the consent process prior to surgery and can be used to build predictive models for individual outcome.

Identifiants

pubmed: 39196407
doi: 10.1007/s00586-024-08425-0
pii: 10.1007/s00586-024-08425-0
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

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Auteurs

Daniel Haschtmann (D)

Department of Spine Surgery, Schulthess Klinik, Zurich, Switzerland. daniel.haschtmann@kws.ch.
Department of Orthopaedic Surgery and Traumatology, Inselspital, University of Bern, Bern, Switzerland. daniel.haschtmann@kws.ch.

Christian Brand (C)

SwissRDL, Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland.

Tamas F Fekete (TF)

Department of Spine Surgery, Schulthess Klinik, Zurich, Switzerland.

Dezsö Jeszenszky (D)

Department of Spine Surgery, Schulthess Klinik, Zurich, Switzerland.

Frank S Kleinstück (FS)

Department of Spine Surgery, Schulthess Klinik, Zurich, Switzerland.

Raluca Reitmeir (R)

Department of Spine Surgery, Schulthess Klinik, Zurich, Switzerland.

François Porchet (F)

Department of Spine Surgery, Schulthess Klinik, Zurich, Switzerland.

Laura Zimmermann (L)

Department of Teaching, Research and Development, Spine Center Division, Schulthess Klinik, Zurich, Switzerland.

Markus Loibl (M)

Department of Spine Surgery, Schulthess Klinik, Zurich, Switzerland.

Anne F Mannion (AF)

Department of Teaching, Research and Development, Spine Center Division, Schulthess Klinik, Zurich, Switzerland.

Classifications MeSH