Achieving Optimal Outcome for Degenerative Lumbar Spondylolisthesis

Ghogawala, Zoher; Resnick, Daniel K.; Glassman, Steven D.; Dziura, James; Shaffrey, Christopher I.; Mummaneni, Praveen V.

doi:10.1093/neuros/nyx207

Cited by 13 publications

(11 citation statements)

References 14 publications

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“…Less-invasive decompression techniques might suppress the postoperative progression of instability to within a certain rate, but even such techniques could not resolve this problem completely. 2 , 10) In fact, we have encountered some patients who suffered from severe deformity several years after less-invasive decompression surgeries and needed revision fusion surgery.…”

Section: Discussionmentioning

confidence: 99%

Preliminary Results on Radiological Hypermobility at Upper Adjacent Disc Level in Posterior Lumbar Interbody Fusion Compared to Advanced Dynamic Stabilization

Ohtonari

Kitagawa

Ota

et al. 2020

Neurol. Med. Chir.(Tokyo)

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Whether posterior lumbar interbody fusion (PLIF) is effective in patients older than 55 years remains questionable because of the high prevalence of adjacent segment disease. We retrospectively investigated early clinical outcomes and radiological changes at upper adjacent disc (UAD) level in such age-group patients who underwent advanced dynamic stabilization (ADS) or PLIF. ADS or PLIF were performed in patients with grade 1 spondylolisthesis or disc degeneration complicated by apparent vacuum phenomenon. All patients suffered from neurological symptoms in lower limbs with/without low back pain. In all, 16 patients (six females; mean age, 69.0 ± 8.5 years) who underwent ADS and 14 patients (seven females; mean age, 67.8 ± 9.3 years) who underwent PLIF were followed-up, and preoperative and postoperative final disc height (DH) and range of motion (ROM) were investigated retrospectively using dynamic radiography at the operated and UAD levels. Clinical data of patients who underwent ADS and PLIF were as follows: postoperative follow-up, 459.3 ± 263.5 and 507.7 ± 288.3 days; preoperative Japanese Orthopaedic Association (JOA) score, 14.4 ± 4.1 and 13.4 ± 4.5; and recovery rate of JOA score, 67.5 ± 18.5 and 50.1 ± 23.4%, respectively. Recovery rate of JOA score in ADS group was significantly high compared to PLIF group (P = 0.044). At UAD level, ROM decreased from 4.7 ± 2.9° preoperatively to 3.6 ± 2.6° postoperatively in the ADS group and increased from 3.4 ± 4.1° preoperatively to 5.6 ± 2.8° postoperatively with significant hypermobility (P = 0.020) in the PLIF group. ADS has the advantage in clinical outcomes even in the postoperative early stage, avoiding the early hypermobility at UAD level, compared to PLIF in patients older than 55 years.

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Section: Discussionmentioning

confidence: 99%

Preliminary Results on Radiological Hypermobility at Upper Adjacent Disc Level in Posterior Lumbar Interbody Fusion Compared to Advanced Dynamic Stabilization

Ohtonari

Kitagawa

Ota

et al. 2020

Neurol. Med. Chir.(Tokyo)

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“…The authors of the SLIP trial argue that ODI scores may become better over time. The change in ODI score from baseline for the two groups at four years was on the verge of statistical significance, with a p -value of 0.05 [6,8]. However, they state that the lack of power is a major concern for focusing on ODI scores when analyzing the two groups [8].…”

Section: Reviewmentioning

confidence: 99%

“…The change in ODI score from baseline for the two groups at four years was on the verge of statistical significance, with a p -value of 0.05 [6,8]. However, they state that the lack of power is a major concern for focusing on ODI scores when analyzing the two groups [8]. On the other hand, the SLIP study authors argue that the Swedish study population was heterogenous and did not identify which patients had instability or the number of levels treated, raising concern that their findings of "no benefit" could have been influenced by these shortcomings [8].…”

Section: Reviewmentioning

confidence: 99%

“…However, they state that the lack of power is a major concern for focusing on ODI scores when analyzing the two groups [8]. On the other hand, the SLIP study authors argue that the Swedish study population was heterogenous and did not identify which patients had instability or the number of levels treated, raising concern that their findings of "no benefit" could have been influenced by these shortcomings [8]. In summary, the Swedish study provides level II evidence stating that there is no difference between the decompression-alone group and the decompression plus fusion group.…”

Section: Reviewmentioning

confidence: 99%

“…In summary, the Swedish study provides level II evidence stating that there is no difference between the decompression-alone group and the decompression plus fusion group. The SLIP study, on the other hand, provides level I evidence for the efficacy of fusion to improve outcomes and lower reoperation rates compared to the decompressive laminectomy alone for patients with spinal stenosis and nonmobile single-level grade 1 spondylolisthesis [8].…”

Section: Reviewmentioning

confidence: 99%

See 2 more Smart Citations

Comparison of Lumbar Laminectomy Alone, Lumbar Laminectomy and Fusion, Stand-alone Anterior Lumbar Interbody Fusion, and Stand-alone Lateral Lumbar Interbody Fusion for Treatment of Lumbar Spinal Stenosis: A Review of the Literature

Shah¹,

Kolb²,

Yılmaz³

et al. 2019

Cureus

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Lumbar spinal stenosis is defined as narrowing of the lumbar spinal canal, which causes compression of the spinal cord and nerves. Spinal stenosis can cause leg pain and potentially back pain that can affect the quality of life. Ultimately, surgical decompression is required to alleviate the symptoms. In this review, we first utilize several important studies to compare lumbar laminectomy alone versus lumbar laminectomy and fusion. We also compare the effectiveness of more novel surgical approaches, stand-alone anterior lumbar interbody fusion (ALIF), and stand-alone lateral lumbar interbody fusion (LLIF). These techniques have their own advantages and disadvantages in which many factors must be taken into account before choosing a surgical approach. In addition, the patient’s anatomy and pathology, lifestyle, and desires should be analyzed to help determine the ideal surgical strategy

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Patient-Reported Outcomes

Dunbar

Ghogawala

2018

Quality Spine Care

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Achieving Optimal Outcome for Degenerative Lumbar Spondylolisthesis

Cited by 13 publications

References 14 publications

Preliminary Results on Radiological Hypermobility at Upper Adjacent Disc Level in Posterior Lumbar Interbody Fusion Compared to Advanced Dynamic Stabilization

Preliminary Results on Radiological Hypermobility at Upper Adjacent Disc Level in Posterior Lumbar Interbody Fusion Compared to Advanced Dynamic Stabilization

Comparison of Lumbar Laminectomy Alone, Lumbar Laminectomy and Fusion, Stand-alone Anterior Lumbar Interbody Fusion, and Stand-alone Lateral Lumbar Interbody Fusion for Treatment of Lumbar Spinal Stenosis: A Review of the Literature

Patient-Reported Outcomes

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