The London Spine Unit : the highest rated treatment facility in UK
Published article
CONCLUSION: Our study suggests that both direct and indirect decompression for the treatment of lumbar spondylolisthesis result in similar clinical outcomes, with the exception that those treated with indirect decompression experienced a lower reduction in back and leg pain at 3-months and a higher 3-month reoperation rate. This data can provide surgeons with additional information when counseling patients on the pros and cons of ID versus DD surgery.
Lumbar Decompression Surgery Expert. Best Spinal Surgeon UK
Spine (Phila Pa 1976). 2022 Jul 15. doi: 10.1097/BRS.0000000000004396. Online ahead of print.
ABSTRACT
STUDY DESIGN: Retrospective Review.
OBJECTIVE: To compare outcomes at 3 and 12-months for patients with lumbar spondylolisthesis treated with direct decompression (DD) versus indirect decompression (ID) techniques.
SUMMARY OF BACKGROUND DATA: Debate persists regarding the optimal surgical strategy to treat lumbar spondylolisthesis. Novel techniques relying on ID have shown superior radiographic outcomes compared to DD, however, doubt remains regarding their effectiveness in achieving adequate decompression. Currently, there is a paucity of data comparing the clinical efficacy of DD to ID.
METHODS: The Quality Outcomes Database (QOD), a national, multicenter prospective spine registry, was queried for patients who underwent DD and ID between 04/13-01/19. Propensity scores (PS) for each treatment were estimated using logistic regression dependent on baseline covariates potentially associated with outcomes. The PS’s were used to exclude non-similar patients. Multivariable regression analysis was performed with the treatment and covariate as independent variables and outcomes as dependent variables.
RESULTS: 4163 patients were included in the DD group and 86 in the ID group. The ID group had significantly lower odds of having a longer hospital stay and for achieving 30% improvement in back and leg pain at 3-months. These trends were not statistically significant at 12-months. There were no differences in ED5D scores or ODI 30% improvement scores at 3 or 12-months. ID patient had a significantly higher rate of undergoing a repeat operation at 3 months (4.9% vs. 1.5%, P=0.015).
CONCLUSION: Our study suggests that both direct and indirect decompression for the treatment of lumbar spondylolisthesis result in similar clinical outcomes, with the exception that those treated with indirect decompression experienced a lower reduction in back and leg pain at 3-months and a higher 3-month reoperation rate. This data can provide surgeons with additional information when counseling patients on the pros and cons of ID versus DD surgery.
PMID:35867585 | DOI:10.1097/BRS.0000000000004396
The London Spine Unit : the highest rated treatment facility in UK
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