Cargando…

Symptomatic lumbar stenosis due to low-grade degenerative spondylolisthesis can effectively be treated with mere decompression

PURPOSE: Adding instrumented spondylodesis to decompression in symptomatic spinal stenosis with degenerative spondylolisthesis is subject of debate. The presence of spondylolisthesis due to degeneration is an indicator of severe facet joint and intervertebral disc degeneration, and this may fit incr...

Descripción completa

Detalles Bibliográficos
Autores principales: van Grafhorst, Judith M. P., Dijkerman, Manon L., Peul, Wilco C., Vleggeert-Lankamp, Carmen L. A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Vienna 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10409655/
https://www.ncbi.nlm.nih.gov/pubmed/37410183
http://dx.doi.org/10.1007/s00701-023-05667-7
_version_ 1785086290895568896
author van Grafhorst, Judith M. P.
Dijkerman, Manon L.
Peul, Wilco C.
Vleggeert-Lankamp, Carmen L. A.
author_facet van Grafhorst, Judith M. P.
Dijkerman, Manon L.
Peul, Wilco C.
Vleggeert-Lankamp, Carmen L. A.
author_sort van Grafhorst, Judith M. P.
collection PubMed
description PURPOSE: Adding instrumented spondylodesis to decompression in symptomatic spinal stenosis with degenerative spondylolisthesis is subject of debate. The presence of spondylolisthesis due to degeneration is an indicator of severe facet joint and intervertebral disc degeneration, and this may fit increased instability of the spine. We aim to establish the incidence of degenerative spondylolisthesis in spinal stenosis surgical candidates and to evaluate the incidence of failure of decompressive surgery without concomitant spondylodesis as initial treatment. METHODS: Medical files of all operated patients for spinal stenosis between 2007 and 2013 were evaluated. Demographic characteristics, pre-operative radiological characteristics (level of stenosis, presence, and grade of spondylolisthesis), surgical technique, incidence, and indication for reoperation were summarised, as well as the type of reoperation. Patient satisfaction was classified as ‘satisfied’ or ‘unsatisfied’ after initial and secondary surgery. The follow-up was 6 to 12 years. RESULTS: Nine hundred thirty-four patients were included, and 253 (27%) had a spondylolisthesis. Seventeen percent of the spondylolisthesis patients receiving decompression were reoperated versus 12% of the stenosis patients (p=.059). Reoperation in the spondylolisthesis group concerned instrumented spondylodesis in 38 versus 10% in the stenosis group. The satisfaction percentage was comparable in the stenosis and the spondylolisthesis group two months after surgery (80 vs. 74%). Of the 253 spondylolisthesis patients, 1% initially received instrumented spondylodesis and 6% in a second operation. CONCLUSION: Lumbar stenosis with and without (low-grade) degenerative spondylolisthesis can usually effectively be treated with mere decompression. Instrumented surgery in a second surgical procedure does not lead to less satisfaction with surgical outcomes.
format Online
Article
Text
id pubmed-10409655
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher Springer Vienna
record_format MEDLINE/PubMed
spelling pubmed-104096552023-08-10 Symptomatic lumbar stenosis due to low-grade degenerative spondylolisthesis can effectively be treated with mere decompression van Grafhorst, Judith M. P. Dijkerman, Manon L. Peul, Wilco C. Vleggeert-Lankamp, Carmen L. A. Acta Neurochir (Wien) Original Article PURPOSE: Adding instrumented spondylodesis to decompression in symptomatic spinal stenosis with degenerative spondylolisthesis is subject of debate. The presence of spondylolisthesis due to degeneration is an indicator of severe facet joint and intervertebral disc degeneration, and this may fit increased instability of the spine. We aim to establish the incidence of degenerative spondylolisthesis in spinal stenosis surgical candidates and to evaluate the incidence of failure of decompressive surgery without concomitant spondylodesis as initial treatment. METHODS: Medical files of all operated patients for spinal stenosis between 2007 and 2013 were evaluated. Demographic characteristics, pre-operative radiological characteristics (level of stenosis, presence, and grade of spondylolisthesis), surgical technique, incidence, and indication for reoperation were summarised, as well as the type of reoperation. Patient satisfaction was classified as ‘satisfied’ or ‘unsatisfied’ after initial and secondary surgery. The follow-up was 6 to 12 years. RESULTS: Nine hundred thirty-four patients were included, and 253 (27%) had a spondylolisthesis. Seventeen percent of the spondylolisthesis patients receiving decompression were reoperated versus 12% of the stenosis patients (p=.059). Reoperation in the spondylolisthesis group concerned instrumented spondylodesis in 38 versus 10% in the stenosis group. The satisfaction percentage was comparable in the stenosis and the spondylolisthesis group two months after surgery (80 vs. 74%). Of the 253 spondylolisthesis patients, 1% initially received instrumented spondylodesis and 6% in a second operation. CONCLUSION: Lumbar stenosis with and without (low-grade) degenerative spondylolisthesis can usually effectively be treated with mere decompression. Instrumented surgery in a second surgical procedure does not lead to less satisfaction with surgical outcomes. Springer Vienna 2023-07-06 2023 /pmc/articles/PMC10409655/ /pubmed/37410183 http://dx.doi.org/10.1007/s00701-023-05667-7 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Original Article
van Grafhorst, Judith M. P.
Dijkerman, Manon L.
Peul, Wilco C.
Vleggeert-Lankamp, Carmen L. A.
Symptomatic lumbar stenosis due to low-grade degenerative spondylolisthesis can effectively be treated with mere decompression
title Symptomatic lumbar stenosis due to low-grade degenerative spondylolisthesis can effectively be treated with mere decompression
title_full Symptomatic lumbar stenosis due to low-grade degenerative spondylolisthesis can effectively be treated with mere decompression
title_fullStr Symptomatic lumbar stenosis due to low-grade degenerative spondylolisthesis can effectively be treated with mere decompression
title_full_unstemmed Symptomatic lumbar stenosis due to low-grade degenerative spondylolisthesis can effectively be treated with mere decompression
title_short Symptomatic lumbar stenosis due to low-grade degenerative spondylolisthesis can effectively be treated with mere decompression
title_sort symptomatic lumbar stenosis due to low-grade degenerative spondylolisthesis can effectively be treated with mere decompression
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10409655/
https://www.ncbi.nlm.nih.gov/pubmed/37410183
http://dx.doi.org/10.1007/s00701-023-05667-7
work_keys_str_mv AT vangrafhorstjudithmp symptomaticlumbarstenosisduetolowgradedegenerativespondylolisthesiscaneffectivelybetreatedwithmeredecompression
AT dijkermanmanonl symptomaticlumbarstenosisduetolowgradedegenerativespondylolisthesiscaneffectivelybetreatedwithmeredecompression
AT peulwilcoc symptomaticlumbarstenosisduetolowgradedegenerativespondylolisthesiscaneffectivelybetreatedwithmeredecompression
AT vleggeertlankampcarmenla symptomaticlumbarstenosisduetolowgradedegenerativespondylolisthesiscaneffectivelybetreatedwithmeredecompression