Patient Outcomes in the Operative and Nonoperative Management of High-Grade Spondylolisthesis in Children

Lundine, Kristopher; Lewis, Stephen J.; Al-Aubaidi, Zaid; Alman, Benjamin A.; Howard, Andrew

doi:10.1097/bpo.0000000000000133

Cited by 32 publications

(19 citation statements)

References 12 publications

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“…Finally, 5 eligible studies were identified, consisting of 1 observational case series, 10 1 prospective database, 13 and 3 retrospective cohort studies. 6 , 11 , 12 Table 1 provides a summary of characteristics of these studies, including author, year of publication, nation, and study design, number of patients, follow-up time, operative or nonoperative intervention, and clinical outcome. Of the 5 articles selected for inclusion, 3 studies measured the outcome of the treatment on the HRQOL (questionnaire) and 2 studies measured radiographic evidence of progression of slip.…”

Section: Resultsmentioning

confidence: 99%

“…The studies showed in general problems with follow-up and missing data for each variable of interest. The quality of the studies was in general considered low 10 or moderate 6 , 11 , 13 ranging from 5 to 7 points according to the NOS-scale (see Table 2 ). One study was judged as a high-quality study with 8 points.…”

Section: Resultsmentioning

confidence: 99%

“… 10 , 13 In another study, patients with persistent low back pain or radiating pain or progression of the slip to 30% of the body of the slip vertebra were included to consider surgical treatment. 12 Lundine et al 11 suggested that the patients with significant dysfunction and deformity, progressive pain, and neurologic compromise should be strongly considered for operative intervention. In their opinion, conservative management did not lead to a large group of dissatisfied for growing patients with high-grade slips.…”

Section: Resultsmentioning

confidence: 99%

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Surgical Versus Nonsurgical Treatment for High-Grade Spondylolisthesis in Children and Adolescents

Xue

Wei

Li³

2016

Medicine

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The optimal management of high-grade spondylolisthesis in children and adolescent is controversial. There is a paucity of literature regarding operatively or nonoperative management in this setting.To assessment of the current state of evidence regarding high-grade spondylolisthesis treatment with the goal of obtaining outcome comparisons in these patients managed either operatively or nonoperatively.We performed a systematic literature search up to November 2014, using Medline, Embase, and The Cochrane Library. The analysis and eligibility criteria were documented according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA-guidelines) and Cochrane Back Review Group editorial board. We used the Newcastle–Ottawa quality assessment scale (NOS-scale) to assess the quality.Five observational studies were considered eligible for analysis based on the evaluation of 1596 identified papers. The mean overall difference in the Scoliosis Research Society questionnaire 22 between the surgical and nonsurgical groups was not statistically significant (95% CI: −0.17 to 0.21, P = 0.84). The pooled mean difference in progression of slip between the surgical and nonsurgical groups was no significant difference (OR: 0.47, 95% CI: 0.12–1.81, P = 0.27, I2 = 0%).Because of the preponderance of uncontrolled case series, low-quality evidence indicates that the quality of life and progression of slips was no significant difference between surgery and nonoperation group. Nonoperative patients had no radiologic progression of their slip during the follow-up period.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Surgical Versus Nonsurgical Treatment for High-Grade Spondylolisthesis in Children and Adolescents

Xue

Wei

Li³

2016

Medicine

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“…Так, Lundine et al [42] свидетельствуют об отсутствии различий в жалобах и качестве жизни у пациентов, перенесших операцию по поводу спондилолистеза, и у детей и подростков, получавших консервативную терапию. При этом риск неблагоприятного результата выше при исходно более высокой степени спондилолистеза в обеих группах.…”

Section: сочетанные патологииunclassified

Scoliosis and Spondylolisthesis: Literature Review

Mikhaylovskiy¹,

Sadovoy²,

Belozerov³

2017

Hir. pozvonoč

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At present, there are no reliable prognostic factors indicating the progressive nature of spondylolisthesis in children and adolescents. Often the main complaint is a pain syndrome, which is well arrested by conservative therapy, while the quality of life of patients without surgery is not significantly impaired. The presented review of the literature shows that it is better to correct scoliotic deformity at a younger age when indications arise. Isthmic spondylolisthesis and scoliosis should be considered as different pathologies. In the absence of convincing evidence that spondylolisthesis has caused the scoliosis development, indications for surgical treatment should be considered as those for individual pathologies. Isolated correction of scoliotic deformity does not lead to a progression of scoliosis. Papers of Russian and foreign authors from e-Library, Medline and PubMed databases were reviewed. The evidence level in majority of papers is III(C), and in part of papers-II(B).

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“…Хирургическое лечение спондилолистезов высокой степени в настоящее время представляет собой актуальную проблему. Не разработан алгоритм выбора метода хирургического лечения пациентов с данной патологией, остаются дискуссионными способы хирургического лечения, исполь зование редукционных маневров, отсутствуют исследования высокой степени достоверности [22,26,27]. Описаны несколько способов хирургического лечения спондилолистезов высокой степени: задний спондилодез аутокостью in situ (техника Wiltse), инструментальная фиксация in situ с задним спондилодезом аутокостью, корригирующий межтеловой спондилодез (по Dubousset) [28], редукция позвонка с межтеловым спондилодезом, в том числе вышележащего сегмента с транспедикулярной фиксацией, транссакральная винтовая фиксация in situ [29,30].…”

Section: Introductionunclassified

Surgical treatment of lower lumbar spine pathology in children and adolescents

Krutko

Владимирович²,

Sanginov

et al. 2018

Pediatr Traum Orthop Reconstr Surg

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Introduction. Analysis of the modern literature shows that the number of children complaining of low back pain of varying intensity in the spine increases annually. Publications on the surgical treatment of juvenile osteochondrosis were scarce. Currently, there are no algorithms for choosing a surgical treatment for children and adolescents with lumbar spine pathology, particularly high-grade listhesis, methods and terms of surgical treatment, and the use of reduction maneuvers remain debatable. There are no high-quality evidence studies. Aim. This study aimed to summarize the experience of treatment of children and adolescents with pathology of the lower lumbar spine. Material and methods. We performed a retrospective analysis of the treatment outcomes in patients with lower lumbar spine pathology who were younger than 18 years and who underwent surgery in the Neurosurgical Department No. 2 of the Tsiv’yan Novosibirsk Research Institute of Traumatology and Orthopedics between 2008 and 2018. The mean age of the patients was 15.5 years. We structured pathologies and interventions in children and adolescents and evaluated the clinical and radiological outcomes of treatment and the rate of intraoperative and postoperative complications. Results and discussion. From 2008 to 2018, 11,428 patients with degenerative spine disease and isthmic/dysplastic spondylolisthesis underwent surgery at the Neurosurgical Department No. 2. Of these, 55 (0.5%) patients were younger than 18 years. In all patients, surgical treatment led to pain relief and physical activity recovery. Decompression/stabilization surgery through the posterior approach enabled formation of an artificial block in 100% of cases. The rate of surgical treatment complications was 8.6% and 28.6% in children and adolescents with herniated lumbar intervertebral discs and spondylolisthesis, respectively. Conclusion. Surgical treatment of children and adolescents with pathology of the lower lumbar spine demonstrated an excellent clinical outcome. Disc herniation did not recur 4.9 years after decompression surgery for herniated lumbar intervertebral discs. Decompression/stabilization surgery through the posterior approach in children and adolescents with spondylolisthesis facilitated abolition of pain, regression of neurological disorders, full recovery of physical activity, and formation of a reliable artificial block. Potential complications were resolved without consequences and did not downplay the importance of surgical techniques in the treatment of this group of patients.

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Patient Outcomes in the Operative and Nonoperative Management of High-Grade Spondylolisthesis in Children

Abstract: Level III.

Cited by 32 publications

References 12 publications

Surgical Versus Nonsurgical Treatment for High-Grade Spondylolisthesis in Children and Adolescents

Surgical Versus Nonsurgical Treatment for High-Grade Spondylolisthesis in Children and Adolescents

Scoliosis and Spondylolisthesis: Literature Review

Surgical treatment of lower lumbar spine pathology in children and adolescents

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