Surgical outcomes between posterior decompression alone and posterior decompression with fusion surgery among patients with Meyerding grade 2 degenerative spondylolisthesis: a multicenter cohort study

• Published in: BMC musculoskeletal disorders Vol. 23; no. 1; pp. 1 - 902
• Main Authors: Tozawa, Keiichiro, Matsubayashi, Yoshitaka, Kato, So, Doi, Toru, Taniguchi, Yuki, Kumanomido, Yudai, Higashikawa, Akiro, Yosihida, Yuichi, Kawamura, Naohiro, Sasaki, Katsuyuki, Azuma, Seiichi, Yu, Jim, Hara, Nobuhiro, Iizuka, Masaaki, Ono, Takashi, Fukushima, Masayoshi, Takeshita, Yujiro, Tanaka, Sakae, Oshima, Yasushi
• Format: Journal Article
• Language: English
• Published: London BioMed Central Ltd 08.10.2022; BioMed Central; BMC
• Subjects: Back pain; Back surgery; Body mass index; Canals (anatomy); Central canal stenosis; Clinical outcomes; Cohort analysis; Decompression; Fusion; Hematoma; Hospitalization; Low back pain; Medical imaging; Meyerding grade 2 degenerative spondylolisthesis; Multicenter retrospective cohort study; Musculoskeletal diseases; Patient-reported outcome measure; Patients; Radiography; Scoliosis; Spine (lumbar); Spondylolisthesis; Stenosis; Surgery; Surgical outcomes; Surgical site infections; Urinary tract diseases; Urinary tract infections; Urogenital system; Vertebrae; Japan; United States > US
• ISSN: 1471-2474; 1471-2474
• DOI: 10.1186/s12891-022-05850-4

Abstract Background Whether lumbar decompression with fusion surgery is effective against Meyerding grade 2 degenerative spondylolisthesis (DS) is unknown. Therefore, the current study aimed to compare the surgical outcomes between posterior decompression alone and posterior decompression with fusion surgery among patients with grade 2 DS with central canal stenosis. Methods This retrospective cohort study included prospectively registered patients (n = 3863) who underwent surgery for degenerative lumbar spinal canal stenosis at nine high-volume spine centers from April 2017 to July 2019. Patients with grade 2 DS and central canal stenosis were included in the analysis. Patients with radiculopathy, including foraminal stenosis, degenerative scoliosis, and concomitant anterior spinal fusion, and those with a previous history of lumbar surgery were excluded. The participants were divided into the decompression alone group (group D) and decompression with fusion surgery group (group F). Data about patient-reported outcomes, including Numeric Rating Scale (low back pain, leg pain, leg numbness, and foot numbness), Oswestry Disability Index, EuroQol Five-Dimensional questionnaire, and 12-Item Short-Form Health Survey scores, were obtained preoperatively and 2 years postoperatively. Results In total, 2354 (61%) patients, including 42 (1.8%) with grade 2 DS (n = 18 in group D and n = 24 in group F), completed the 2-year follow-up. Group D had a higher proportion of female patients than group F. However, the two groups did not significantly differ in terms of other baseline demographic characteristics. Group D had a significantly shorter surgical time and lower volume of intraoperative blood loss than group F. Postoperative patient-reported outcomes did not significantly differ between the two groups, although the preoperative degree of low back pain was higher in group F than in group D. The slip degree of group D did not worsen during the follow-up period. Conclusion The surgical outcomes were similar regardless of the addition of fusion surgery among patients with grade 2 DS. Decompression alone was superior to decompression with fusion surgery as it was associated with a lower volume of intraoperative blood loss and shorter surgical time.