Surgery in lumbar degenerative spondylolisthesis: indications, outcomes and complications. A systematic review

Steiger, F.; Becker, Heinrich; Standaert, Christopher J.; Balagué, Federico; Vader, John‐Paul; Porchet, François; Mannion, Anne F.

doi:10.1007/s00586-013-3144-3

Cited by 99 publications

(79 citation statements)

References 29 publications

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“…3,9,20 There have been reports that segmental instability in LDS is related to the cause and progress of slippage. 1,4,7 For this reason, because conventional procedures for decompression involving surgical invasion of facet joints and surrounding soft tissue could increase instability and exacerbate clinical symptoms, decompression combined with fusion is recommended.…”

Section: Discussionmentioning

confidence: 99%

“…However, there is currently no consensus on the criteria for selecting these two procedures. 9,20 It has been reported that for cases with a large degree of slippage, the standard procedure is fusion, 6 but the evidence for this has not been clarified. On the other hand, the progress of slippage decreases during the natural course of LDS, and restabilization occurs.…”

mentioning

confidence: 99%

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Outcomes in cases of lumbar degenerative spondylolisthesis more than 5 years after treatment with minimally invasive decompression: examination of pre- and postoperative slippage, intervertebral disc changes, and clinical results

Mori¹,

Matsumura²,

Ikeda³

et al. 2016

SPI

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OBJECT There are reports that fusion is the standard treatment of choice for cases of lumbar degenerative spondylolisthesis (LDS) associated with lumbar spinal canal stenosis with a large degree of slippage. The reasons why, however, have not been clarified. On the other hand, it is known that the progress of slippage decreases and restabilization occurs over the natural course of LDS. Therefore, if minimally invasive decompression could be performed, there would be little possibility of it influencing the natural course of LDS, so it would not be necessary to include preoperative percentage slip in the criteria for the selection of fusion. This study examined the course of LDS cases more than 5 years after treatment with minimally invasive decompression to determine whether pre- and postoperative slippage and disc changes influence the clinical results. METHODS A total of 51 intervertebral segments in 51 cases with the chief complaint of radicular or cauda equina symptoms due to lumbar spinal canal stenosis were examined after prospective treatment with minimally invasive decompression for LDS. The mean age of the patients at the time of surgery was 66.7 years and the mean follow-up period was 7 years 4 months. Minimally invasive decompression was performed regardless of the degree of low-back pain or percentage slip. The outcome variables were clinical results and changes in imaging findings. RESULTS Over the follow-up period, postoperative percentage slip increased and disc height decreased, but the Japanese Orthopaedic Association score improved. Regardless of the preoperative percentage slip, disc height, or degree of intervertebral disc degeneration or segmental instability, the clinical results were favorable. In the high preoperative percentage slip group, low disc height group, and progressive disc degeneration group, there was little postoperative progress of slippage. In the group with a postoperative slippage increase of more than 5%, slippage increased significantly at postoperative year 2, but no significant difference was observed at the final follow-up. CONCLUSIONS When minimally invasive decompression was performed to treat LDS, the postoperative change in slippage was no different from that during the natural course. Furthermore, regardless of the degree of preoperative slippage or intervertebral disc degeneration, the clinical results were favorable. Also, the higher the preoperative percentage slip and the more that disc degeneration progressed, the more the progress of postoperative slippage decreased. Because the postoperative progress of slippage decreased, it is believed that even after minimally invasive decompression, restabilization occurs as it would during the natural course. If minimally invasive decompression can be performed to treat LDS, it is believed that preoperative percentage slip and intervertebral disc degeneration do not have to be included in the appropriateness criteria for fusion.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Outcomes in cases of lumbar degenerative spondylolisthesis more than 5 years after treatment with minimally invasive decompression: examination of pre- and postoperative slippage, intervertebral disc changes, and clinical results

Mori¹,

Matsumura²,

Ikeda³

et al. 2016

SPI

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“…In that study, adding spinal fusion did not lead to significantly better outcome (Matsudaira et al 2005). This notion was actually supported by a recent large register study from Sweden (Försth et al 2013) and a recent systematic review on DS stated there to be insufficient evidence to draw conclusions regarding indications for specific types of surgical treatment (Steiger et al 2014).…”

Section: Spinal Fusion and Outcomementioning

confidence: 99%

“…According to systematic reviews (Martin et al 2007;Steiger et al 2014), adding spinal fusion to decompression is considered preferred treatment in spinal stenosis with concomitant DS. In the U.S. 83% of patients with DS undergo fusion when being decompressed (Bae et al 2013).…”

Section: The Role Of Spinal Fusion In Dsmentioning

confidence: 99%

“…In the U.S. 83% of patients with DS undergo fusion when being decompressed (Bae et al 2013). The evidence for generalizing including fusion in DS is inadequate (Herkowitz and Kurz 1991;Bridwell et al 1993;Ghogawala et al 2004;Matsudaira et al 2005;Försth et al 2013;Steiger et al 2014). The main evidence for generally performing a concomitant fusion derives from 2 RCT's, but neither explored the role of pain predominance and outcome (Herkowitz and Kurz 1991;Bridwell et al 1993).…”

Section: The Role Of Spinal Fusion In Dsmentioning

confidence: 99%

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Determinants of outcome in lumbar spinal stenosis surgery

Sigmundsson¹

2014

Acta Orthopaedica

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Cover illustration: "Spine Talk", acryl paint on stretched canvas. The painting was created in 2008 by the Canadian artist Barbara C. St Jean and is a painting of two people talking to each other over top of a spine of another. The painting was created to illustrate the problems associated with back pain and the discussions with medical professionals over the causes and treatment options. By permission from the artist.

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Comparative Effectiveness of Microdecompression Alone vs Decompression Plus Instrumented Fusion in Lumbar Degenerative Spondylolisthesis

et al. 2020

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Surgery in lumbar degenerative spondylolisthesis: indications, outcomes and complications. A systematic review

Cited by 99 publications

References 29 publications

Outcomes in cases of lumbar degenerative spondylolisthesis more than 5 years after treatment with minimally invasive decompression: examination of pre- and postoperative slippage, intervertebral disc changes, and clinical results

Outcomes in cases of lumbar degenerative spondylolisthesis more than 5 years after treatment with minimally invasive decompression: examination of pre- and postoperative slippage, intervertebral disc changes, and clinical results

Determinants of outcome in lumbar spinal stenosis surgery

Comparative Effectiveness of Microdecompression Alone vs Decompression Plus Instrumented Fusion in Lumbar Degenerative Spondylolisthesis

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