Study design—A subanalysis study. Objective—To compare surgical outcomes and complications of multilevel decompression and single level fusion to multilevel decompression and multilevel fusion for patients with multilevel lumbar stenosis and single level degenerative spondylolisthesis. Summary of Background Data—In patients with degenerative spondylolisthesis who are treated surgically, decompression and fusion provides a better clinical outcome than decompression alone. Surgical treatment for multilevel lumbar stenosis and degenerative spondylolisthesis typically includes decompression and fusion of the spondylolisthesis segment and decompression with or without fusion for the other stenotic segments. To date, no study has compared the results of these two surgical options for single level degenerative spondylolisthesis with multilevel stenosis. Methods—The results from a multicenter randomized and observational study, the Spine Patient Outcomes Research Trial (SPORT) comparing multilevel decompression and single level fusion and multilevel decompression and multilevel fusion for spinal stenosis with spondylolisthesis, were analyzed. The primary outcomes measures were the Bodily Pain and Physical Function scales of the Medical Outcomes Study 36-item Short-Form General Health Survey (SF-36) and the modified Oswestry Disability Index at 1, 2, 3 and 4 years postoperatively. Secondary analysis consisted of stenosis bothersomeness index, low back pain bothersomeness, leg pain, patient satisfaction, and self-rated progress. Results—Overall 207 patients were enrolled to the study, 130 had multilevel decompression with one level fusion and 77 patients had multilevel decompression and multilevel fusion. For all primary and secondary outcome measures, there were no statistically significant differences in surgical outcomes between the two surgical techniques. However, operative time and intraoperative blood loss were significantly higher in the multilevel fusion group. Conclusion—Decompression and single level fusion and decompression and multilevel fusion provide similar outcomes in patients with multilevel lumbar stenosis and single level degenerative spondylolisthesis.
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Study design—A subanalysis study. Objective—To compare surgical outcomes and complications of multilevel decompression and single level fusion to multilevel decompression and multilevel fusion for patients with multilevel lumbar stenosis and single level degenerative spondylolisthesis. Summary of Background Data—In patients with degenerative spondylolisthesis who are treated surgically, decompression and fusion provides a better clinical outcome than decompression alone. Surgical treatment for multilevel lumbar stenosis and degenerative spondylolisthesis typically includes decompression and fusion of the spondylolisthesis segment and decompression with or without fusion for the other stenotic segments. To date, no study has compared the results of these two surgical options for single level degenerative spondylolisthesis with multilevel stenosis. Methods—The results from a multicenter randomized and observational study, the Spine Patient Outcomes Research Trial (SPORT) comparing multilevel decompression and single level fusion and multilevel decompression and multilevel fusion for spinal stenosis with spondylolisthesis, were analyzed. The primary outcomes measures were the Bodily Pain and Physical Function scales of the Medical Outcomes Study 36-item Short-Form General Health Survey (SF-36) and the modified Oswestry Disability Index at 1, 2, 3 and 4 years postoperatively. Secondary analysis consisted of stenosis bothersomeness index, low back pain bothersomeness, leg pain, patient satisfaction, and self-rated progress. Results—Overall 207 patients were enrolled to the study, 130 had multilevel decompression with one level fusion and 77 patients had multilevel decompression and multilevel fusion. For all primary and secondary outcome measures, there were no statistically significant differences in surgical outcomes between the two surgical techniques. However, operative time and intraoperative blood loss were significantly higher in the multilevel fusion group. Conclusion—Decompression and single level fusion and decompression and multilevel fusion provide similar outcomes in patients with multilevel lumbar stenosis and single level degenerative spondylolisthesis.
Copyright remains with the authors and publisher.