Interbody Fusion in Low Grade Lumbar Spondylolsithesis: Clinical Outcome Does Not Correalte with Slip Reduction and Neural Foraminal Dimension

Ujjwal K. Debnath; Atanu Chatterjee; Jeffrey R. McConnell; Deepak K. Jha; Tapas Chakraburtty

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자료유형: 학술저널

저자정보: Ujjwal K. Debnath (Ramakrishna Mission Seva Pratisthan) Atanu Chatterjee (Ramakrishna Mission Seva Pratisthan) Jeffrey R. McConnell (Ramakrishna Mission Seva Pratisthan) Deepak K. Jha (Ramakrishna Mission Seva Pratisthan) Tapas Chakraburtty (Ramakrishna Mission Seva Pratisthan)

저널정보: 대한척추외과학회 Asian Spine Journal Asian Spine Journal Vol.10 No.2

발행연도: 2016.1

수록면: 314 - 320 (7page)

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Study Design: Prospective nonrandomized study. Purpose: To find a possible correlation between clinical outcome and extent of lumbar spondylolisthesis reduction. Overview of Literature: There is no consensus in the literature concerning whether a beneficial effect of reduction on outcome can be expected following reduction and surgical fusion for low grade lumbar spondylolisthesis. Methods: Forty six patients with a mean age of 37.5 years (age, 17–48 years) with isthmic spondylolisthesis underwent interbody fusion with cages with posterior instrumentation (TLIF). Clinical outcome was measured using visual analogue score (VAS) and Oswestry disability index (ODI). Foraminal dimensions and disc heights were measured in standard digital radiographs. These were analyzed at baseline and 1 year after surgery and changes were compared. Radiographic fusion was judged with computed tomography scans at 1 year. Results: Ninety percent of the patients had good or very good clinical results with fusion and instrumentation. Baseline and one-year postoperative mean VAS score was 6.33 (range, 5–8) and 0.76 (range, 0–3), respectively (p =0.004). Baseline and one-year postoperative, mean ODI score was 48 (range, 32–62) and 10 (range, 6–16), respectively (p <0.001). A mean spondylolisthesis slip of 32.1% was reduced to 6.7% at 1 year. Average anterior disc height, posterior disc height, vertical foraminal dimension), and foraminal) diameter improved from 9.8 to 11.7 mm (p =0.005), 4.5 to 5.8 mm (p =0.004), 11.3 to 12.6 mm (p =0.002), and 18.6 to 20.0 mm (p <0.001), respectively. The fusion rate was 75% with TLIF. There is no significant correlation between the improvements of ODI scores and the extent of slip reduction. Conclusions: Neural decompression and interbody fusion can significantly improve pain and disability but the clinical outcome does not correlate with radiological improvement in the neural foraminal dimension.

참고문헌 (1)

참고문헌 신청

Ogilvie JW / 2005 / Complications in spondylolisthesis surgery / Spine (Phila Pa 1976) 30(6 Suppl):S97~S101

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