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Outcomes in Lumbar Fusion Patients Stratified by the Clinical and Radiographic Degenerative Spondylolisthesis (CARDS) Classification System – Lumbar Fusion

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The article evaluates the Clinical and Radiographic Degenerative Spondylolisthesis (CARDS) classification system for patients undergoing lumbar fusion for degenerative lumbar spondylolisthesis (DLS). The study classified patients into four CARDS groups based on disc height, kyphosis, and anterior translation. The findings showed that patients across different CARDS groups had similar demographic and clinical characteristics, as well as similar clinical and patient-reported outcomes post-surgery. The study also noted varying interbody fusion utilization across the different CARDS groups. The results suggest that posterolateral fusion can be effective for various radiographic presentations of DLS, and further research is needed to assess the utility of CARDS in preoperative planning

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : most established spinal clinic in the world

Published article

Background and objective The Meyerding classification system remains the most common classification system for spondylolisthesis based on the percentages of vertebral translation. However, the majority of patients with degenerative disease fall into Grade 1, limiting its utility in this subset of patients. The Clinical and Radiographic Degenerative Spondylolisthesis (CARDS) classification system provides a simple radiographic framework for classifying degenerative lumbar spondylolisthesis (DLS)…

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Cureus. 2024 Feb 14;16(2):e54177. doi: 10.7759/cureus.54177. eCollection 2024 Feb.ABSTRACTBackground and objective The Meyerding classification system remains the most common classification system for spondylolisthesis based on the percentages of vertebral translation. However, the majority of patients with degenerative disease fall into Grade 1, limiting its utility in this subset of patients. The Clinical and Radiographic Degenerative,

Cureus. 2024 Feb 14;16(2):e54177. doi: 10.7759/cureus.54177. eCollection 2024 Feb.

ABSTRACT

Background and objective The Meyerding classification system remains the most common classification system for spondylolisthesis based on the percentages of vertebral translation. However, the majority of patients with degenerative disease fall into Grade 1, limiting its utility in this subset of patients. The Clinical and Radiographic Degenerative Spondylolisthesis (CARDS) classification system provides a simple radiographic framework for classifying degenerative lumbar spondylolisthesis (DLS) patients by incorporating disc height, kyphosis, and anterior translation. The purpose of this study was to evaluate how clinical characteristics, treatments, and outcomes vary across different CARDS groups in patients undergoing one- or two-level lumbar fusion for DLS. Methods The patients were classified into one of the following four CARDS groups – Type A: advanced disc space collapse with no evidence of kyphosis; Type B: partially preserved disc space with less than 5.0 mm of translation; Type C: partially preserved disc space with greater than 5.0 mm of translation; and Type D: kyphotic alignment. Univariate analyses were performed to compare demographics, symptoms, clinical outcomes, and Patient-Reported Outcomes Measurement Information System (PROMIS) physical (PH) and mental health (MH) scores across groups. Results Ninety-one patients were included in the study. Based on the CARDS classification, there were three (3%) Type A patients, 25 (28%) Type B, 58 (64%) Type C, and five (5%) Type D. No significant differences in baseline demographics, symptom duration, or PROMIS scores were observed across groups. Interbody utilization varied, ranging from 19% in CARDS C (n=11) to 60% in CARDS B (n=15) and D (n=3) patients (p=0.005). Thirty-day clinical outcomes were similar across groups. At an average follow-up of 8.9 months, improvements in PROMIS PH and MH scores and rates of clinically significant improvement were similar across groups. s Based on our findings, patients undergoing lumbar fusion for DLS present with similar demographic and clinical characteristics and experience similar clinical and patient-reported outcomes when stratified using the CARDS classification system. Posterolateral fusion (PLF) can be effective for various radiographic presentations of DLS. Further research is warranted to assess the utility of CARDS in preoperative planning.

PMID:38496088 | PMC:PMC10941802 | DOI:10.7759/cureus.54177

The London Spine Unit : most established spinal clinic in the world

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Outcomes in Lumbar Fusion Patients Stratified by the Clinical and Radiographic Degenerative Spondylolisthesis (CARDS) Classification System

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Cureus. 2024 Feb 14;16(2):e54177. doi: 10.7759/cureus.54177. eCollection 2024 Feb.ABSTRACTBackground and objective The Meyerding classification system remains the most common classification system for spondylolisthesis based on the percentages of vertebral translation. However, the majority of patients with degenerative disease fall into Grade 1, limiting its utility in this subset of patients. The Clinical and Radiographic Degenerative
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