Comparing Investigation Between Bilateral Partial Laminectomy and Posterior Lumbar Interbody Fusion for Mild Degenerative Spondylolisthesis

Abstract

Objective: The present study aims to compare the surgical outcomes between bilateral partial laminectomy (BPL) and posterior lumbar interbody fusion (PLIF) in patients with mild degree of slippage. Summary of Background Data:To date, there have not been established surgical procedures for patients with mild degree of slippage. Moreover, sufficient studies that have compared surgical outcomes between BPL and PLIF are very few. Materials and Methods:In this retrospective study, the authors enrolled 202 consecutive patients with degenerative spondylolisthesis with slippage at L3 or L4 of > 3% who underwent spine surgery between 2005 and 2015. Patients were grouped into those who underwent single-segment PLIF (n = 106) and those who underwent BPL (n = 51). To adjust for potential confounders, the inverse probability of treatment weighting based on the propensity score was used. Surgical outcomes were compared between the BPL and PLIF groups. The threshold age for the final recovery rate of > 70% was evaluated using receiver operating characteristic curve analyses to assess the limit of age to achieve good outcomes. Patients who underwent reoperation in both groups were also evaluated.Results: Operation time and blood loss were significantly lower in the BPL group. The final recovery rate was similar between the groups without age stratification. The cutoff age to achieve a final recovery rate of > 70% was 75 years in the PLIF group, and the final recovery rate was significantly higher in the PLIF group than in the BPL group in patients aged less than 75 years but not in patients aged 75 years or older. In addition, the reoperation rate was similar between groups, and all reoperations in the PLIF group were for adjacent segment disease.Conclusions: BPL is one of the useful options in patients with mild degenerative spondylolisthesis, particularly in patients aged more than 75 years.

Rate of Reoperation Following Decompression-Only Procedure for Lumbar Degenerative Spondylolisthesis

“…After an initial screening of titles and abstracts, we excluded 1,432 studies. The full texts of the 128 remaining studies were then examined against our inclusion criteria, leading to the inclusion of 23 studies 5,6,9,12-31 incorporating 1,865 patients. Among the included studies, reporting reoperation data for decompression-only procedures, only Bisson et al 25 made a direct comparison of different approaches for performing decompression-only procedures.…”

“…We analyzed 23 studies 5,6,9,12-31 with 1,865 patients reporting the reoperation rate of decompression-only procedure for lumbar degenerative spondylolisthesis. We noted significant heterogeneity among the included studies (I 2 = 79.66%, p < 0.01) and consequently a random-effects model single-arm meta-analysis was conducted.…”

Effects of Cage Implantation Depth on Sagittal Parameters and Functional Outcomes in Posterior Lumbar Interbody Fusion for the Treatment of L4‐L5 Lumbar Degenerative Spondylolisthesis

“…For some patients, conservative treatment is ineffective, and posterior lumbar interbody fusion (PLIF) surgery has become the main treatment method in recent years. 1 , 2 , 3 , 4 , 5 Pedicle screws provide temporary stability of the spine, but continued stability depends on intervertebral fusion. The key to interbody fusion lies in the cage.…”

“…Patients diagnosed with lumbar degenerative spondylolisthesis (LDS) frequently exhibit clinical manifestations including low back pain, sciatica, and neurogenic claudication. For some patients, conservative treatment is ineffective, and posterior lumbar interbody fusion (PLIF) surgery has become the main treatment method in recent years 1–5 . Pedicle screws provide temporary stability of the spine, but continued stability depends on intervertebral fusion.…”