Does preoperative degenerative spondylolisthesis influence outcome in degenerative lumbar spinal stenosis? 3-year results of a Swiss prospective multicenter cohort study.

Does preoperative degenerative spondylolisthesis influence outcome in degenerative lumbar spinal stenosis? 3-year results of a Swiss prospective multicenter cohort study.

World Neurosurg. 2018 Apr 04;:

Authors: Harry-Bert Ulrich N, Gravestock I, Held U, Schawkat K, Pichierri G, Wertli MM, Winklhofer S, Farshad M, Porchet F, Steurer J, Burgstaller JM

Abstract
BACKGROUND: Decompression alone to treat degenerative lumbar stenosis with and without concomitant degenerative spondylolisthesis (DS; non-DS) has shown ambiguous results in the literature.
OBJECTIVE: The aim is to compare clinical outcomes in patients with lumbar stenosis with and without DS who underwent decompression alone surgery without fusion on one to three adjacent levels after 6-, 12-, 24-, and 36-month follow-up.
METHODS: We conducted a prospective cohort study at eight medical centers. The main outcomes of this study are changes in Spinal Stenosis Measure (SSM) symptoms score, SSM function score, and quality of life (EQ-5D-3L sum score) over time. Propensity score matching for DS versus non-DS was applied.
RESULTS: One hundred seventy-seven patients meet the inclusion criteria, of which 68 had DS. In the matched cohort (n=136), the estimated difference in SSM symptoms score of DS versus non-DS for changes from baseline to 36 months is 0.21 (95% CI -0.15 to 0.57). For SSM function score, the estimated difference from baseline to 36 months is 0.05 (-0.21 to 0.31). Differences in changes between groups in EQ-5D-3L sum score are estimated to be -3.66 (-10.63 to 3.31) from baseline to 36 months. None of the group differences between the non-DS and the DS group are statistically significant. All matched patients improve over time in all additional outcomes.
CONCLUSION: Even after three years of follow-up we demonstrate that among the patients with degenerative lumbar spinal stenosis, both groups - with and without degenerative spondylolisthesis - distinctively take advantage of decompression alone without fusion.

PMID: 29626686 [PubMed - as supplied by publisher]

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