Surgical Outcomes and Limitations of Decompression Surgery for Degenerative Spondylolisthesis

STUDY DESIGN: A retrospective study. OBJECTIVES: To investigate surgical outcomes and limitations of decompression surgery for degenerative spondylolisthesis. METHODS: One hundred patients with degenerative spondylolisthesis who underwent decompression surgery alone were included in this study. The average follow-up period was 3.7 years. Radiography and magnetic resonance imaging were used for radiological assessment. Patients with a recovery rate of >50% throughout the study period were classified as the control group (Group C), while those with a recovery rate of <50% throughout the study period were classified as the poor group (Group P). Patients that had improved symptoms, and yet later showed neurological deterioration due to foraminal stenosis at the same level were classified as the exiting nerve root radiculopathy group (Group E), while those who showed deterioration due to slip progression at the same level were classified as the traversing nerve root radiculopathy group (Group T). RESULTS: Patient distribution in each group was 73, 12, 7, and 8 in Groups C, P, E, and T, respectively. As for preoperative radiological features, slippage and an upper migrated disc in Group P, disc wedging and an upper migrated disc in Group E, and lamina inclination and posterior opening in Group T were evident. The cutoff value of preoperative slippage with a poor outcome was 13%. CONCLUSIONS: Surgical outcomes of decompression surgery for degenerative spondylolisthesis were successful in 73% cases. Preoperative radiological features for poor outcomes were slippage of more than 13%, an upper migrated disc, disc wedging, and lamina inclination.