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Severe Intervertebral Vacuum Phenomenon is Associated With Higher Preoperative Low Back Pain, ODI, and Indication for Fusion in Patients With Degenerative Lumbar Spondylolisthesis – Lumbar Spinal Stenosis

This article is a retrospective study that analyzes the association between intervertebral vacuum phenomenon (IVP) and clinical parameters in patients with degenerative spondylolisthesis. The study found that the severity of vacuum phenomenon at L4/L5 was associated with greater preoperative back pain and worse Oswestry Disability Index. Patients with severe IVP were also more likely to undergo fusion surgery. The findings suggest that assessing the severity of IVP can help determine the appropriate treatment approach for patients with degenerative spondylolisthesis

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
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Published article

CONCLUSION: Our study showed that in patients with degenerative spondylolisthesis undergoing surgery, the severity of vacuum phenomenon at L4/L5 was associated with greater preoperative back pain and worse Oswestry Disability Index. Patients with severe IVP were more likely to undergo fusion.

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Clin Spine Surg. 2023 Aug 25. doi: 10.1097/BSD.0000000000001510. Online ahead of print.ABSTRACTSTUDY DESIGN: Retrospective study of prospective collected data.OBJECTIVE: To analyze the association between intervertebral vacuum phenomenon (IVP) and clinical parameters in patients with degenerative spondylolisthesis.SUMMARY OF BACKGROUND DATA: IVP is a sign of advanced disc degeneration. The correlation between IVP severity and low back,

Clin Spine Surg. 2023 Aug 25. doi: 10.1097/BSD.0000000000001510. Online ahead of print.

ABSTRACT

STUDY DESIGN: Retrospective study of prospective collected data.

OBJECTIVE: To analyze the association between intervertebral vacuum phenomenon (IVP) and clinical parameters in patients with degenerative spondylolisthesis.

SUMMARY OF BACKGROUND DATA: IVP is a sign of advanced disc degeneration. The correlation between IVP severity and low back pain in patients with degenerative spondylolisthesis has not been previously analyzed.

METHODS: We retrospectively analyzed patients with degenerative spondylolisthesis who underwent surgery. Vacuum phenomenon was measured on computed tomography scan and classified into mild, moderate, and severe. A lumbar vacuum severity (LVS) scale was developed based on vacuum severity. The associations between IVP at L4/5 and the LVS scale, preoperative and postoperative low back pain, as well as the Oswestry Disability Index was assessed. The association of IVP at L4/5 and the LVS scale and surgical decision-making, defined as decompression alone or decompression and fusion, was assessed through univariable logistic regression analysis.

RESULTS: A total of 167 patients (52.7% female) were included in the study. The median age was 69 years (interquartile range 62-72). Overall, 100 (59.9%) patients underwent decompression and fusion and 67 (40.1%) underwent decompression alone. The univariable regression demonstrated a significantly increased odds ratio (OR) for back pain in patients with more severe IVP at L4/5 [OR=1.69 (95% CI 1.12-2.60), P=0.01]. The univariable regressions demonstrated a significantly increased OR for increased disability with more severe L4/L5 IVP [OR=1.90 (95% CI 1.04-3.76), P=0.04] and with an increased LVS scale [OR=1.17 (95% CI 1.02-1.35), P=0.02]. IVP severity of the L4/L5 were associated with higher indication for fusion surgery.

CONCLUSION: Our study showed that in patients with degenerative spondylolisthesis undergoing surgery, the severity of vacuum phenomenon at L4/L5 was associated with greater preoperative back pain and worse Oswestry Disability Index. Patients with severe IVP were more likely to undergo fusion.

PMID:37651562 | DOI:10.1097/BSD.0000000000001510

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Severe Intervertebral Vacuum Phenomenon is Associated With Higher Preoperative Low Back Pain, ODI, and Indication for Fusion in Patients With Degenerative Lumbar Spondylolisthesis

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Clin Spine Surg. 2023 Aug 25. doi: 10.1097/BSD.0000000000001510. Online ahead of print.ABSTRACTSTUDY DESIGN: Retrospective study of prospective collected data.OBJECTIVE: To analyze the association between intervertebral vacuum phenomenon (IVP) and clinical parameters in patients with degenerative spondylolisthesis.SUMMARY OF BACKGROUND DATA: IVP is a sign of advanced disc degeneration. The correlation between IVP severity and low back

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