For a study, it was determined that during fusion for spondylolisthesis, it was common to reduce Meyerding grade. Although radiographic appearance may improve, patient-reported outcomes (PROs) were rarely documented. The authors’ goal in this study was to see how spondylolisthesis reduction affected 24-month PRO measures after Meyerding grade I degenerative lumbar spondylolisthesis decompression and fusion surgery. Patients receiving posterior lumbar fusion for spondylolisthesis with a minimum 24-month follow-up were searched by Researchers in the Quality Outcomes Database (QOD). Researchers did a quantitative association between Meyerding slippage reduction and PROs. The Oswestry Disability Index (ODI), EQ-5D, Numeric Rating Scale (NRS)–back pain (NRS-BP), NRS-leg pain (NRS-LP), and satisfaction (North American Spine Society patient satisfaction questionnaire) ratings were recorded by them at baseline and 24-month intervals. After controlling for various preoperative and surgical factors, they built multivariable regression models for 24-month PROs and complications. The magnitude of slippage decrease was calculated and linked with PROs. The patients were separated into two groups: those who had a less than 3 mm reduction and those who had more than or equal to 3 mm reduction.
The QOD found 206 patients with complete data from 608 patients from 12 collaborating locations, and these patients were included in this study. Except for depression, listhesis size, and the proportion of patients with dynamic listhesis, baseline patient demographics, comorbidities, and clinical features were similar among cohorts (accounted for in the multivariable analysis). About 104 patients (50.5%) had lumbar decompression and fusion with a slippage reduction of fewer than three millimeters (mean 5.19, range 3 to 11), and 102 (49.5%) had lumbar decompression and fusion with a slippage reduction of less than 3 mm (mean 0.41, range 2 to 2). There was no significant difference in PROs between patients with and without intraoperative listhesis reduction (ODI, EQ-5D, NRS-BP, NRS-LP, or satisfaction) on univariate and multivariate analysis. Complications did not differ significantly between cohorts. Patients having decompression and fusion for lumbar spondylolisthesis showed significant improvement in all PROs. There was no link between clinical results and Meyerding slippage reduction magnitude.
Reference:thejns.org/spine/view/journals/j-neurosurg-spine/36/2/article-p177.xml
