P115. Patients with degenerative spondylolisthesis maintain clinically relevant improvement five years after surgery

Abstract

BACKGROUND CONTEXT Degenerative spondylolisthesis (DS) is a common condition in the elderly population which is associated with significant morbidity and decreased quality of life. For patients where pain and disability are unacceptable, surgical intervention with lumbar decompression is a commonly used treatment option, shown to provide relief of symptoms and pain. Few studies have examined if a clinically relevant difference in function is obtained, and whether this effect is sustained at long term. PURPOSE The aim of this study was to evaluate patient reported outcomes and whether patients obtain a clinically relevant improvement after surgery, and if the effect of treatment is sustained at 1, 2 and 5 years postoperatively. STUDY DESIGN/SETTING The study was performed as a retrospective cohort study on patients who underwent surgery at the Spine Centre of Southern Denmark, Middelfart, the Regional Hospital of Silkeborg and University Hospital of Zealand in Koge. PATIENT SAMPLE A total of 1,241 patients had surgery for LSS with DS during the inclusion period. All patients underwent decompression and non-instrumented fusion. We had follow-up data available on our main outcome measure (ODI) on 79.8% at 1 year, 74.8% at 2 year, and 74.2% at 5-year follow-up. OUTCOME MEASURES Oswestry Disability Index (ODI), EuroQoL-5D-3L (EQ-5D), Visual Analogue Scale Leg Pain (VAS-leg) and Visual Analogue Scale Back Pain (VAS-back). METHODS The study was performed as a multicentre registry-based retrospective cohort study using data collected prospectively in the Danish national surgical spine database; DaneSpine. In DaneSpine, patient reported outcomes are collected preoperatively, and 1, 2,5 and 10 years postoperative. This study evaluates both preoperative and postoperative outcomes. Data was collected via patient reported questionnaires, all PRO measures were filled out preoperatively and at 1, 2 and 5 years postoperatively. Based on the outcome measures, the patients who obtained a minimal clinically relevant difference in outcome (MCID) were identified at 1, 2 and 5 years postsurgery. RESULTS We found a mean change from 1 to 5 years of -20.9 on ODI; a mean change of 0.22 on EQ.5D, 30.5 on VAS leg and 20.6 on VAS back. We found that 90% of patients obtained a clinically relevant increase in one or more PROs. Apart from VAS back, there was no statistical difference in percentage of patients who obtained MCID at 1, 2 and 5-years postsurgery. CONCLUSIONS Surgery for LSS with DS has favorable results, with most patients experiencing a clinically important change in outcome measures that is maintained for at least 5 years. Of the patients who undergo surgery for LSS with DS, 90% can expect a meaningful change in outcome measures on at least one parameter. FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs.