Decompression without Fusion for Low-Grade Degenerative Spondylolisthesis
Study DesignRetrospective series.PurposeAssess results of decompression-only surgery for low-grade degenerative spondylolisthesis with consideration of instability.Overview of LiteratureThere is no consensus on whether fusion or decompression-only surgery leads to better outcomes for patients with l...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Korean Spine Society
2016-02-01
|
| Series: | Asian Spine Journal |
| Subjects: | |
| Online Access: | http://www.asianspinejournal.org/upload/pdf/asj-10-75.pdf |
| _version_ | 1818268407382933504 |
|---|---|
| author | Jason Pui Yin Cheung Prudence Wing Hang Cheung Kenneth Man Chee Cheung Keith Dip Kei Luk |
| author_facet | Jason Pui Yin Cheung Prudence Wing Hang Cheung Kenneth Man Chee Cheung Keith Dip Kei Luk |
| author_sort | Jason Pui Yin Cheung |
| collection | DOAJ |
| description | Study DesignRetrospective series.PurposeAssess results of decompression-only surgery for low-grade degenerative spondylolisthesis with consideration of instability.Overview of LiteratureThere is no consensus on whether fusion or decompression-only surgery leads to better outcomes for patients with low-grade degenerative spondylolisthesis. Current trends support fusion but many studies are flawed due to over-generalization without consideration of radiological instability and their variable presentations and natural history.MethodsPatients with surgically treated degenerative spondylolisthesis from 1990–2013 were included. Clinical and radiological instability measures were included. Any residual or recurrence of symptoms, revision surgery performed and functional outcome scores including the numerical global rate of change scale, visual analogue scale, and modified Barthel index were measured. Follow-up periods for patients were divided into short-term (<5 years), mid-term (5–10 years) and long-term (>10 years).ResultsA total of 64 patients were recruited. Mechanical low back pain was noted in 48 patients and most (85.4%) had relief of back pain postoperatively. Radiological instability was noted in 4 subjects by flexion-extension radiographs and 12 subjects with prone traction radiographs by increased disc height and reduction of olisthesis and slip angle. From the results of the short-term, mid-term and long-term follow-up, reoperation only occurred within the first 5-year follow-up period. All functional scores improved from preoperative to postoperative 1-year follow-up.ConclusionsDecompression-only for low-grade degenerative spondylolisthesis has good long-term results despite instability. Further higher-level studies should be performed on this patient group with radiological instability to suggest the superior surgical option. |
| first_indexed | 2024-12-12T20:38:00Z |
| format | Article |
| id | doaj.art-3503ed50d00a4e389bb0c6cb383cb6dc |
| institution | Directory Open Access Journal |
| issn | 1976-1902 1976-7846 |
| language | English |
| last_indexed | 2024-12-12T20:38:00Z |
| publishDate | 2016-02-01 |
| publisher | Korean Spine Society |
| record_format | Article |
| series | Asian Spine Journal |
| spelling | doaj.art-3503ed50d00a4e389bb0c6cb383cb6dc2022-12-22T00:12:51ZengKorean Spine SocietyAsian Spine Journal1976-19021976-78462016-02-01101758410.4184/asj.2016.10.1.75149Decompression without Fusion for Low-Grade Degenerative SpondylolisthesisJason Pui Yin Cheung0Prudence Wing Hang Cheung1Kenneth Man Chee Cheung2Keith Dip Kei Luk3Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong, SAR, China.Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong, SAR, China.Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong, SAR, China.Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong, SAR, China.Study DesignRetrospective series.PurposeAssess results of decompression-only surgery for low-grade degenerative spondylolisthesis with consideration of instability.Overview of LiteratureThere is no consensus on whether fusion or decompression-only surgery leads to better outcomes for patients with low-grade degenerative spondylolisthesis. Current trends support fusion but many studies are flawed due to over-generalization without consideration of radiological instability and their variable presentations and natural history.MethodsPatients with surgically treated degenerative spondylolisthesis from 1990–2013 were included. Clinical and radiological instability measures were included. Any residual or recurrence of symptoms, revision surgery performed and functional outcome scores including the numerical global rate of change scale, visual analogue scale, and modified Barthel index were measured. Follow-up periods for patients were divided into short-term (<5 years), mid-term (5–10 years) and long-term (>10 years).ResultsA total of 64 patients were recruited. Mechanical low back pain was noted in 48 patients and most (85.4%) had relief of back pain postoperatively. Radiological instability was noted in 4 subjects by flexion-extension radiographs and 12 subjects with prone traction radiographs by increased disc height and reduction of olisthesis and slip angle. From the results of the short-term, mid-term and long-term follow-up, reoperation only occurred within the first 5-year follow-up period. All functional scores improved from preoperative to postoperative 1-year follow-up.ConclusionsDecompression-only for low-grade degenerative spondylolisthesis has good long-term results despite instability. Further higher-level studies should be performed on this patient group with radiological instability to suggest the superior surgical option.http://www.asianspinejournal.org/upload/pdf/asj-10-75.pdfLow-gradeDegenerativeSpondylolisthesisDecompressionWithoutFusion |
| spellingShingle | Jason Pui Yin Cheung Prudence Wing Hang Cheung Kenneth Man Chee Cheung Keith Dip Kei Luk Decompression without Fusion for Low-Grade Degenerative Spondylolisthesis Asian Spine Journal Low-grade Degenerative Spondylolisthesis Decompression Without Fusion |
| title | Decompression without Fusion for Low-Grade Degenerative Spondylolisthesis |
| title_full | Decompression without Fusion for Low-Grade Degenerative Spondylolisthesis |
| title_fullStr | Decompression without Fusion for Low-Grade Degenerative Spondylolisthesis |
| title_full_unstemmed | Decompression without Fusion for Low-Grade Degenerative Spondylolisthesis |
| title_short | Decompression without Fusion for Low-Grade Degenerative Spondylolisthesis |
| title_sort | decompression without fusion for low grade degenerative spondylolisthesis |
| topic | Low-grade Degenerative Spondylolisthesis Decompression Without Fusion |
| url | http://www.asianspinejournal.org/upload/pdf/asj-10-75.pdf |
| work_keys_str_mv | AT jasonpuiyincheung decompressionwithoutfusionforlowgradedegenerativespondylolisthesis AT prudencewinghangcheung decompressionwithoutfusionforlowgradedegenerativespondylolisthesis AT kennethmancheecheung decompressionwithoutfusionforlowgradedegenerativespondylolisthesis AT keithdipkeiluk decompressionwithoutfusionforlowgradedegenerativespondylolisthesis |