This article discusses a study that aimed to identify the preoperative factors that affect the patient-reported outcome in individuals with Meyerding grade I degenerative spondylolisthesis undergoing lumbar spinal stenosis surgery. The study included 72 patients who underwent minimally invasive decompression alone or with fusion. The parameters investigated included pain evaluation questionnaire and measures of sagittal alignment. The results showed that preoperative L4 slippage and lumbar axis sacral distance were significant factors affecting the postoperative outcome. Patients with a preoperative L4 slippage of 6 mm or more had a lower rate of improvement in lumbar spine dysfunction, while those with a preoperative lumbar axis sacral distance of 30 mm or more had a higher rate of improvement. The study also suggested that fusion surgery may be more advantageous in improving lumbar dysfunction due to low back pain in patients with a preoperative lumbar axis sacral distance of 30 mm or more
Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : most specialised treatment facility on Harley Street UK
Published article
CONCLUSIONS: Preoperative L4S and LASD were extracted as significant preoperative factors affecting patient-reported outcomes at 2 years postoperatively. Multiple logistic analyses by the operative method suggested that DF may be advantageous in improving lumbar dysfunction due to low back pain in patients with preoperative LASD of 30 mm or more.
Spine Lumbar Spinal Stenosis Expert. Best Spinal Surgeon UK
Abstract Background: The choice of operative method for lumbar spinal stenosis with Meyerding grade I degenerative spondylolisthesis remains controversial. The purpose of this study was to identify the preoperative factors affecting the 2-year postoperative patient-reported outcome in Meyerding grade I degenerative spondylolisthesis. Methods: Seventy-two consecutive patients who had minimally invasive decompression alone (D group; 28),
Abstract
Background: The choice of operative method for lumbar spinal stenosis with Meyerding grade I degenerative spondylolisthesis remains controversial. The purpose of this study was to identify the preoperative factors affecting the 2-year postoperative patient-reported outcome in Meyerding grade I degenerative spondylolisthesis.
Methods: Seventy-two consecutive patients who had minimally invasive decompression alone (D group; 28) or with fusion (DF group; 44) were enrolled. The parameters investigated were the Japanese Orthopaedic Association back pain evaluation questionnaire as patient-reported assessment, and L4 slippage (L4S), lumbar lordosis (LL), and lumbar axis sacral distance (LASD) as an index of sagittal alignment for radiological evaluation. Data collected prospectively at 2 years postoperatively were examined by statistical analysis.
Results: Sixty-two cases (D group; 25, DF group; 37) were finally evaluated. In multiple logistic regression analysis, preoperative L4S and LASD were extracted as significant preoperative factors affecting the 2-year postoperative outcome. Patients with preoperative L4S of 6 mm or more have a lower rate of improvement in lumbar spine dysfunction due to low back pain (risk ratio=0.188, p=.043). Patients with a preoperative LASD of 30 mm or more have a higher rate of improvement in lumbar dysfunction due to low back pain (risk ratio=11.48, p=.021). The results of multiple logistic analysis by operative method showed that there was a higher rate of improvement in lumbar spine dysfunction due to low back pain in patients with preoperative LASD of 30 mm or more in DF group (risk ratio=172.028, p=.01).
Conclusions: Preoperative L4S and LASD were extracted as significant preoperative factors affecting patient-reported outcomes at 2 years postoperatively. Multiple logistic analyses by the operative method suggested that DF may be advantageous in improving lumbar dysfunction due to low back pain in patients with preoperative LASD of 30 mm or more.
Keywords: Degenerative spondylolisthesis; Fusion; Lumbar spinal stenosis; Minimally invasive decompression; Patient-reported assessment; Preoperative factors.
The London Spine Unit : most specialised treatment facility on Harley Street UK
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Preoperative factors affecting the two-year postoperative patient-reported outcome in single-level lumbar grade I degenerative spondylolisthesis
