Surgical versus Nonsurgical Treatment for Lumbar Degenerative Spondylolisthesis

Weinstein, James Neil; Lurie, Jon D.; Tosteson, Tor D.; Hanscom, Brett; Tosteson, Anna N.A.; Blood, Emily A.; Birkmeyer, Nancy J. O.; Hilibrand, Alan S.; Herkowitz, Harry N.; Cammisa, Frank P.; Albert, Todd J.; Emery, Sanford E.; Lenke, Lawrence G.; Abdu, William A.; Longley, Michael; Errico, Thomas J.; Hu, Serena S.

doi:10.1056/nejmoa070302

Cited by 813 publications

(574 citation statements)

References 26 publications

Supporting

Mentioning

541

Contrasting

Unclassified

Order By: Relevance

“…Conversely, most patients (83%) with history of neurogenic claudication or vesicorectal symptoms deteriorated with poor final outcome and these patients should preferably have surgical treatment [38]. Recent study of Weinstein et al [61] found that patients with DS and spinal stenosis treated surgically showed substantially greater improvement in pain and function during a period of 2 years than patients treated nonsurgically. A review by Herkowitz et al [24] suggested that the indications for surgical treatment are:…”

Section: Treatment Optionsmentioning

confidence: 99%

“…There are a number of publications about surgical treatment of signs related to DS [14,21,30,37,39,47,61] including the recent comprehensive review of Sengupta and Herkowitz [51]. In the present review we concentrated on conservative treatment options and would encourage those who are interested in surgery to read these other articles.…”

Section: Treatment Optionsmentioning

confidence: 99%

See 1 more Smart Citation

Diagnosis and conservative management of degenerative lumbar spondylolisthesis

2007

View full text Add to dashboard Cite

Degenerative spondylolisthesis (DS) is a disorder that causes the slip of one vertebral body over the one below due to degenerative changes in the spine. Lumbar DS is a major cause of spinal canal stenosis and is often related to low back and leg pain. We reviewed the symptoms, prognosis and conservative treatments for symptoms associated with DS. PubMed and MEDLINE databases (1950-2007) were searched for

show abstract

Section: Treatment Optionsmentioning

confidence: 99%

Section: Treatment Optionsmentioning

confidence: 99%

Diagnosis and conservative management of degenerative lumbar spondylolisthesis

2007

View full text Add to dashboard Cite

show abstract

“…Lumbar spine fusion has been shown to be effective treatment in both of these disorders when compared to conservative treatment [1,2]. Although lumbar spine fusion surgery (LSF) reduce disability and improve healthrelated quality of life (HRQoL) in patients with several spinal disorders, they do not reach the level of normal population in disability of physical component score of HRQoL at the 1-year follow-up [3].…”

Section: Introductionmentioning

confidence: 99%

Quality of life and disability: can they be improved by active postoperative rehabilitation after spinal fusion surgery in patients with spondylolisthesis? A randomised controlled trial with 12-month follow-up

et al. 2016

View full text Add to dashboard Cite

“…Most implants are used for degenerative spinal diseases, one of which is LSS. The reported successful clinical outcome after bony decompression, the gold standard treatment, is only 64 % and many patients remain to have associated low back pain [5,[7][8][9]. In an effort to improve clinical outcome, a French group introduced a new non-rigid fixation [interspinous process devices (IPDs)] for patients with LSS and associated back pain in 1984: the Wallis system [10][11][12].…”

Section: Interspinous Process Devices Versus Microdecompressionmentioning

confidence: 99%

Minimally invasive surgery for lumbar spinal stenosis

Moojen

Gaag

2016

Eur J Orthop Surg Traumatol

View full text Add to dashboard Cite

Recent trends in spine surgery, such as endoscopic and other ''micro'' techniques, promise less invasive procedures with better outcomes compared to conventional open techniques for decompressing nerves. Minimally invasive surgery (MIS), highly promoted by commercial parties for instrumented cases in particular, is popular with patients and physicians [1]. Widespread adoption of these techniques should always be preceded by careful evaluation to ensure safety and determine added value of such so-called surgical innovation [2,3]. Actual and controversial topics concerning MIS for lumbar spinal stenosis (LSS) were recently addressed in high-quality studies: open laminectomy versus microdecompression by Nerland et al. and decompression versus interspinous process implant by our group [4,5]. In some way, the opposite of MIS was addressed in a recent landmark study by Försth et al.; does decompression versus decompression plus instrumented fusion for LSS yield better outcomes [6]? The three studies address very relevant issues of the neurosurgical daily practice and will be discussed hereafter. The authors analyze data from a large, well-maintained and comprehensive national registry in Norway (the Norwegian Registry for Spine Surgery, NORspine). Thirty six out of 40 centers performing lumbar spine surgery in Norway record data prospectively in NORspine, making it a one of the unique national resource for spine research. Nerland and colleagues identified 885 eligible patients (out of 2745 screened) of whom 81 % completed the 1-year follow-up. Open laminectomy versus microdecompressionOpen laminectomy and microdecompression were associated with similar and statistically equivalent improvements in Oswestry disability scores and quality of life (EuroQol EQ-5D) at 1-year follow-up. Furthermore, the techniques did not differ in older people and obese patients in predefined subgroup analyses. The number of patients with complications was higher in the open laminectomy group (15.0 vs. 9.8 %, P = 0.018), but this difference did not hold after propensity matching (P = 0.23). Patients in the microdecompression group had shorter hospital stays, both for single-level decompression (difference 1.5 days, 95 % confidence interval 1.7-2.6, P \ 0.001) and two-level decompression (0.8 days, 1.0-2.2, P = 0.003).The authors concluded that microdecompression is the treatment of choice for patients with stenosis of the lumbar spine for the technique shows good clinical results, equal to open laminectomy at 1-year follow-up. Theoretically,

show abstract

Surgical versus Nonsurgical Treatment for Lumbar Degenerative Spondylolisthesis

Cited by 813 publications

References 26 publications

Diagnosis and conservative management of degenerative lumbar spondylolisthesis

Diagnosis and conservative management of degenerative lumbar spondylolisthesis

Quality of life and disability: can they be improved by active postoperative rehabilitation after spinal fusion surgery in patients with spondylolisthesis? A randomised controlled trial with 12-month follow-up

Minimally invasive surgery for lumbar spinal stenosis

Contact Info

Product

Resources

About