Increased Proportion of Fusion Surgery for Degenerative Lumbar Spondylolisthesis and Changes in Reoperation Rate

Kim, Chi Heon; Chung, Chun Kee; Choi, Yunhee; Kim, Min Jung; Kim, Myo Jeong; Shin, Sora; Yang, Seung Heon; Hwang, Sung Hwan; Kim, Dong Hwan; Park, Sung Bae; Lee, June Ho

doi:10.1097/brs.0000000000002805

Cited by 34 publications

(23 citation statements)

References 46 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Multiple regression analysis indicated that the change in DH and fusion SL was positively correlated with changes in ODI and VAS scores, respectively, consistent with the findings of previous studies [32]. While previous studies observed a change in sagittal balance at least 2 years after surgery [33,34], we observed similar outcomes in a mean follow-up period of only 6 months. This improvement might be due to better distraction of the intervertebral space, which maintains the stability of the lumbar spine and is conducive to the improvement of clinical effects.…”

Section: Discussionsupporting

confidence: 91%

Caudad Insertion of Pedicle Screws Facilitates Interbody Distraction During Spondylolisthetic Vertebrae Restoration: A Retrospective Study

Zeng

et al. 2021

Pain Ther

View full text Add to dashboard Cite

show abstract

Section: Discussionsupporting

confidence: 91%

Caudad Insertion of Pedicle Screws Facilitates Interbody Distraction During Spondylolisthetic Vertebrae Restoration: A Retrospective Study

Zeng

et al. 2021

Pain Ther

View full text Add to dashboard Cite

show abstract

“…A recent RCT [41] and systematic review [42] also recommended decompression alone for LSS with degenerative spondylolisthesis. There is the opinion that the increased proportion of fusion surgery without improvement in the probability of reoperation in an aging society may be cautiously addressed in deciding future health policies [43]; therefore, minimally invasive lumbar decompression surgery should be considered for LSS with or without degenerative spondylolisthesis. The management of LSS with degenerative deformity is complicated by this consideration.…”

Section: Discussionmentioning

confidence: 99%

Classification and prognostic factors of residual symptoms after minimally invasive lumbar decompression surgery using a cluster analysis: a 5-year follow-up cohort study

et al. 2021

View full text Add to dashboard Cite

Purpose Residual symptoms indicating incomplete remission of lower leg numbness or low back pain may occur after spine surgery. The purpose was to elucidate the pattern of residual symptoms 5 years after minimally invasive lumbar decompression surgery using a cluster analysis. Methods The study comprised 193 patients with lumbar spinal stenosis (LSS) (108 men, 85 women) ranging in age from 40 to 86 years (mean, 67.9 years). Each patient underwent 5-year follow-up. The Japanese Orthopedic Association score and visual analog scale scores for low back pain, leg pain, and leg numbness at 5 years were entered into the cluster analysis to characterize postoperative residual symptoms. Other clinical data were analyzed to detect the factors significantly related to each cluster. ResultsThe analysis yielded four clusters representing different patterns of residual symptoms. Patients in cluster 1 (57.0%) were substantially improved and had few residual symptoms of LSS. Patients in cluster 2 (11.4%) were poorly improved and had major residual symptoms. Patients in cluster 3 (17.6%) were greatly improved but had mild residual low back pain. Patients in cluster 4 (14.0%) were improved but had severe residual leg numbness. Prognostic factors of cluster 2 were a short maximum walking distance, motor weakness, resting lower leg numbness, cofounding scoliosis, and high sagittal vertical axis. Conclusions This is the first study to identify specific patterns of residual symptoms of LSS after decompression surgery. Our results will contribute to acquisition of preoperative informed consent and identification of patients with the best chance of postoperative improvement.

show abstract

“…Open surgery with general anesthesia for the lumbar spine remains challenging. Multiple factors, including old age, osteoporosis and other unfavorable factors, may lead to a poor clinical outcome (20). Furthermore, residual axial lower back pain and adjacent-segment degeneration after instrument implantation are commonly indicated in a number of patients (21).…”

Section: Discussionmentioning

confidence: 99%

Efficacy of percutaneous transforaminal endoscopic decompression treatment for degenerative lumbar spondylolisthesis with spinal stenosis in elderly patients

Jin

et al. 2019

Exp Ther Med

View full text Add to dashboard Cite

The efficacy of fusion combined with decompression for the treatment of spinal stenosis with degenerative lumbar spondylolisthesis (DLS) has been debated. Percutaneous transforaminal endoscopic decompression (PTED) under local anesthesia is an ultra-minimally invasive procedure. The present study aimed to evaluate whether PTED is an effective alternative therapy for spinal stenosis associated with DLS in elderly patients. PTED was performed in elderly patients exhibiting lumbar stenosis and low-grade (Meyerding grades I and II) DLS; these patients also exhibited leg-dominant symptoms and had tolerable or absent mechanical back pain. Administration of general anesthesia may be considerably hazardous in patients when combined with comorbid conditions that result from aging. Therefore, the present procedure was performed under local anesthesia. No obvious radiographic lumbar intervertebral instability was identified prior to surgery. Pre-and post-operative visual analogue scale (VAS) score, Oswestry Disability Index (ODI) and walking distance data were collected. The clinical global outcomes following surgery were evaluated using modified MacNab criteria. A total of 18 elderly patients underwent surgery using PTED techniques. The mean follow-up time was 27.7 months (range, 24-33 months) and the mean estimated blood loss was 18.33 ml (range, 10-35 ml). The mean pre-operative ODI, VAS score of the back and VAS score of the leg were 68.2±6.5, 2.8±1.4 and 6.6±1.2, respectively. All average scores improved post-operatively to 31.7±5.2, 1.5±0.6 and 1.7±0.8, respectively, at the latest follow-up. A statistically significant improvement was observed for all scores at 1 month and that the scores remained relatively stable after that. According to modified MacNab criteria, the good-to-excellent rate was 83.3%. Only 1 patient required micro-decompression surgery due to poor rating. The present study indicated that PTED may be an effective alternative therapeutic option for elderly patients with low-grade DLS associated with spinal stenosis. However, PTED techniques continue to evolve and further follow-up studies are required to determine the long-term outcomes of this treatment technique.

show abstract

Increased Proportion of Fusion Surgery for Degenerative Lumbar Spondylolisthesis and Changes in Reoperation Rate

Abstract: 4.

Cited by 34 publications

References 46 publications

Caudad Insertion of Pedicle Screws Facilitates Interbody Distraction During Spondylolisthetic Vertebrae Restoration: A Retrospective Study

Caudad Insertion of Pedicle Screws Facilitates Interbody Distraction During Spondylolisthetic Vertebrae Restoration: A Retrospective Study

Classification and prognostic factors of residual symptoms after minimally invasive lumbar decompression surgery using a cluster analysis: a 5-year follow-up cohort study

Efficacy of percutaneous transforaminal endoscopic decompression treatment for degenerative lumbar spondylolisthesis with spinal stenosis in elderly patients

Contact Info

Product

Resources

About