Background: The two most common types of surgically treated lumbar spondylolisthesis in adults include the degenerative and isthmic types. The aim of this study was to compare the functional outcomes of surgical decompression and posterolateral instrumented fusion in patients with lumbar degenerative and isthmic spondylolisthesis.
Methods: In this retrospective study, we reviewed the clinical outcomes in surgically treated patients with single level, low grade lumbar degenerative, and isthmic spondylolisthesis (groups A and B, respectively) from August 2007 to April 2011. We tried to compare paired settings with similar initial conditions. Group A included 52 patients with a mean age of 49.2 ± 6.1 years, and group B included 52 patients with a mean age of 47.3 ± 7.4 years. Minimum follow-up was 24 months. The surgical procedure comprised neural decompression and posterolateral instrumented fusion. Pain and disability were assessed by a visual analog scale (VAS) and the Oswestry Disability Index (ODI), respectively. The Wilcoxon and Mann-Whitney U-tests were used to compare indices.
Results: The most common sites for degenerative and isthmic spondylolisthesis were at the L4-L5 (88.5%) and L5-S1 (84.6%) levels, respectively. Surgery in both groups significantly improved VAS and ODI scores. The efficacy of surgery based on subjective satisfaction rate and pain and disability improvement was similar in the degenerative and isthmic groups. Notable complications were also comparable in both groups.
Conclusions: Neural decompression and posterolateral instrumented fusion significantly improved pain and disability in patients with degenerative and isthmic spondylolisthesis. The efficacy of surgery for overall subjective satisfaction rate and pain and disability improvement was similar in both groups.
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| http://dx.doi.org/10.4055/cios.2014.6.2.185 | DOI Listing |
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Article Synopsis
- The study explores the use of epidural fat interposition (EFI) as an indirect indicator for diagnosing spondylolysis (SL) using lumbar MRI, highlighting its significance when analyzing T1-weighted images.
- Out of 115 patients assessed, EFI was present in 85% of those with SL, showing a strong statistical difference compared to those with degenerative disc disease.
- The findings suggest that EFI has high specificity and sensitivity, particularly at the lumbar 5 vertebra level, making it a reliable radiological sign for identifying spondylolysis in MRI scans.
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