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Abstract
BackgroundScoliosis with spondylolisthesis was described in 4.4–48%. No information on clinical impact or outcome is available.PurposeTo determine the prevalence of this pathology and to investigate its affect on the course of adolescent idiopathic scoliosis (AIS).MethodsA retrospective comparative study using patients’ records, radiographs, the national inpatient registry, and Patient-rated outcome measures (PROM): Oswestry disability index (ODI), modif.SRS-24 questionnaire, WHO-Quality of life index (WHOQoL), Numerical rating scale (NRS) for pain. Clinical follow-up time was 4.4 (4.3) years, and follow-up rate was 95%. PROM follow-up time 26.4 (2.8) years χ2 statistics and t-tests were applied. Significance threshold was set at P < 0.05.ResultsOut of 1531 consecutive Caucasian AIS patients, aged 13.9 (1.8) years, primary curve 29.2 (11.5) drs., 120 (7.8%) had low-grade isthmic L5-slip of mean 15.0 (8.3)% (Study group = S). The distribution of the curve types in the study group was comparable to the remaining 1411 patients with AIS only. In comparison with a pair-matched control group (C) at admission, back pain interfering with activities of daily living had 4.2% of the study group and 1.7% of the control group, at clinical follow-up 2.6/4.2% resp. (n.s.). Between groups S/C, there was no significant difference concerning scoliosis treatment: observation 38.3/45.8%, bracing 48.3/46.6%, surgery 10.8/10.2%. Results of treatment were equal in both groups. Long-term outcomes (ODI, SRS-24, WHOQoL, NRS-back/leg pain) were comparable.ConclusionsThe prevalence of low-grade isthmic L5-spondylolisthesis in AIS patients was 7.8%. The presence of low-grade isthmic spondylolisthesis did not influence the curve type of AIS nor did it affect the course or long-term outcome.Graphic abstractThese slides can be retrieved under Electronic Supplementary Material.
Highlights
The occurrence of scoliosis and spondylolisthesis in the same patient is not rare
This is a retrospective analysis from a single institution based on hospital records, patients’ radiographs, the National Inpatient Registry (NIR) of the country, and patient-reported outcome questionnaires (PROM)
To obtain patient-reported long-term outcomes (PROM), the following questionnaires were mailed to the patients of both groups, including one postal reminder to non-responders about two months later: Oswestry Disability Index (ODI) [3], the WHO-Quality of Life questionnaire (WHOQoL) [24], the Numerical Rating Scale (NRS) [8] for back pain and for leg pain, and a shortened version of the SRS-24 [7] using only questions No 1–15
Summary
The occurrence of scoliosis and spondylolisthesis in the same patient is not rare. In the literature, percentages from 4.4 to 48 have been reported. Scoliosis percentages derived from predominantly symptomatic patients with spondylolisthesis do not tell how common this finding is in general. The patient populations presented are of different ages, some study groups are mixtures of high- and low-grade slips, and inconsistent Cobb angle thresholds are applied to define scoliosis. Results Out of 1531 consecutive Caucasian AIS patients, aged 13.9 (1.8) years, primary curve 29.2 (11.5) drs., 120 (7.8%) had low-grade isthmic L5-slip of mean 15.0 (8.3)% (Study group = S). The distribution of the curve types in the study group was comparable to the remaining 1411 patients with AIS only. Conclusions The prevalence of low-grade isthmic L5-spondylolisthesis in AIS patients was 7.8%. The presence of low-grade isthmic spondylolisthesis did not influence the curve type of AIS nor did it affect the course or long-term outcome
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