Patient Outcomes After Decompression and Instrumented Posterior Spinal Fusion for Degenerative Spondylolisthesis

Abstract

A retrospective study of patient outcomes after decompression and fusion for degenerative spondylolisthesis, using the SF-36 survey and a functional questionnaire. In recent studies, patient outcomes have been examined more specifically; however, detailed functional outcomes are not available nor have widely used outcomes instruments been administered. Thirty patients aged more than 40 years (average, 60.1 years) who had degenerative spondylolisthesis were evaluated after decompression and instrumented posterior fusion. Charts and radiographs were also reviewed. Questionnaires were administered by telephone, and consisted of the Medical Outcomes Study short form (SF-36) and 27 questions designed to evaluate function, quality of life, medication usage, and satisfaction with surgical results. Ninety-three percent of patient's were satisfied with their outcomes. Patients improved significantly in their ability to perform heavy and light activities, participate in social activities, sit, and sleep (P < 0.001) and also improved in pain, depression, and medication usage (P < 0.0001). SF-36 data showed significantly better overall assessment of health in all categories than that in a published cohort of patients with low back pain. The current study group also showed no difference in seven of eight categories when compared with the general population. Fusion rate was 93% at an average of 128 days. Three patients required reoperation: two for pseudarthrosis and one for a deep infection. A poorer outcome, scored by the SF-36, was associated with greater preoperative stenosis (P < 0.05) or occurrence of a complication (P < 0.05). Patients treated with decompression and fusion for degenerative spondylolisthesis had improved functional outcomes, when measured by a disease-specific questionnaire and by widely used instruments.