The article discusses the controversial choice of operative method for lumbar spinal stenosis with Meyerding grade I degenerative spondylolisthesis. The study aimed to identify preoperative factors that affect the patient-reported outcome at 2 years postoperatively. The study included 72 patients who underwent either minimally invasive decompression alone or with fusion. The parameters investigated were patient-reported assessment, L4 slippage, lumbar lordosis, and lumbar axis sacral distance. The results showed that preoperative L4 slippage and lumbar axis sacral distance were significant factors affecting the postoperative outcome. Patients with L4 slippage ≥6 mm had a lower rate of improvement in lumbar spine dysfunction, while patients with lumbar axis sacral distance ≥30 mm had a higher rate of improvement. The analysis by operative method suggested that fusion may be advantageous in improving lumbar dysfunction in patients with lumbar axis sacral distance ≥30 mm
Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : best recognised spine 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.
Lumbar Decompression Surgery Expert. Best Spinal Surgeon UK
N Am Spine Soc J. 2023 Aug 23;16:100269. doi: 10.1016/j.xnsj.2023.100269. eCollection 2023 Dec.ABSTRACTBACKGROUND: 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,
N Am Spine Soc J. 2023 Aug 23;16:100269. doi: 10.1016/j.xnsj.2023.100269. eCollection 2023 Dec.
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.
PMID:37731461 | PMC:PMC10507637 | DOI:10.1016/j.xnsj.2023.100269
The London Spine Unit : best recognised spine 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
