Health-related quality of life following decompression compared to decompression and fusion for degenerative lumbar spondylolisthesis: a Canadian multicentre study

作者：Rampersaud Y Raja^*; Fisher Charles; Yee Albert; Dvorak Marcel F; Finkelstein Joel; Wai Eugene; Abraham Edward; Lewis Stephen J; Alexander David; Oxner William

来源：Canadian Journal of Surgery, 2014, 57(4): E126-E133.

DOI：10.1503/cjs.032213

Background: Decompression alone (D) is a well-accepted treatment for patients with lumbar spinal stenosis (LSS) causing neurogenic claudication; however, D is controversial in patients with LSS who have degenerative spondylolisthesis (DLS). Our goal was to compare the outcome of anatomy-preserving D with decompression and fusion (DF) for patients with grade I DLS. We compared patients with DLS who had elective primary 1-2 level spinal D at 1 centre with a cohort who had 1-2 level spinal DF at 5 other centres. %26lt;br%26gt;Methods: Patients followed for at least 2 years were included. Primary analysis included comparison of change in SF-36 physical component summary (PCS) scores and the proportion of patients achieving minimal clinically important difference (MCID) and substantial clinical benefit (SCB). %26lt;br%26gt;Results: There was no significant difference in baseline SF-36 scores between the groups. The average change in PCS score was 10.4 versus 11.4 (p = 0.61) for the D and DF groups, respectively. Sixty-seven percent of the D group and 71% of the DF group attained MCID, while 64% of both D and DF groups attained SCB. There was no significant difference between D and DF for change in PCS score (p = 0.74) or likelihood of reaching MCID (p = 0.81) or SCB (p = 0.85) after adjusting for other variables. %26lt;br%26gt;Conclusion: In select patients with DLS, the outcome of D is comparable to DF at a minimum of 2 years.

• 出版日期2014-8