Postoperative Evaluation of Health-Related Quality-of-Life (HRQoL) of Patients With Lumbar Degenerative Spondylolisthesis After Instrumented Posterolateral Fusion (PLF): A prospective Study With a 2-Year Follow-Up.

S Kapetanakis,P Givissis,G Gkasdaris,E Nastoulis,T Thomaidis,G Charitoudis

doi:10.2174/1874325001711011423

Abstract

Background:Several studies have compared instrumented PLF with other surgical approaches in terms of clinical outcomes, however little is known about the postoperative HRQoL of patients, especially as regards to degenerative spondylolisthesis.Methods:A group of 62 patients, 30 women (48,4%) and 32 men (51,6%) with mean age 56,73 (SD +/- 9,58) years old, were selected to participate in a 2-year follow-up. Their pain was assessed via the visual analogue scale (VAS) for low back pain (VASBP) and leg pain (VASLP) separately. Their HRQoL was evaluated by the Short Form (36) Health Survey (SF-36). Both scales, VAS and SF36, were measured and re-assessed at 10 days, 1 month, 3 months, 6 months, 12 months and 2 years.Results:VASBP, VASLP and each parameter of SF36 presented statistically significant improvement (p<0.01). VASBP, VASLP and SF36 scores did not differ significantly between men and women (p≥0.05). The most notable amelioration of VASBP, VASLP was observed within the first 10 days and the maximum improvement within the first 3 months. From that point, a stabilization of the parameters was observed. The majority of SF36 parameters, and especially PF (physical functioning) and BP (bodily pain), presented statistically significant improvement within the follow up depicting a very similar improvement pattern to that of VAS.Conclusion:We conclude that instrumented PLF ameliorates impressively the HRQoL of patients with degenerative spondylolisthesis after 2 years of follow-up, with pain recession being the most crucial factor responsible for this improvement.

Highlights

Lumbar degenerative spondylolisthesis is a common cause of low back pain and sciatica
After all inclusion and exclusion criteria were considered, we analyzed the results of 62 patients who underwent instrumented Posterolateral instrumented fusion (PLF), in an attempt to evaluate their low back pain (VASBP) and leg pain (VASLP) after surgery, as well as, their postoperative quality of life by measuring the parameters of the SF36 scoring scale as described above
Decompression of the neural elements of the lumbar spine with laminectomy combined with instrumented PLF is a well-established and a time-tested surgical procedure for the treatment of lumbar spondylolisthesis

Summary

Introduction

Lumbar degenerative spondylolisthesis is a common cause of low back pain and sciatica. Posterolateral instrumented fusion (PLF) referring to the combination of lumbar laminectomy for decompression and transpedicular instrumentation using pedicle screws and rods for stability, is one of the two main approaches to spinal fusion; the other is interbody fusion (IBF). Several studies have compared these two surgical approaches in order to evaluate the efficacy of each one of them in terms of pain relief and clinical outcomes [2]. Little is known in the relevant literature about the postoperative quality of life of patients after PLF, especially as regards to degenerative spondylolisthesis. Several studies have compared instrumented PLF with other surgical approaches in terms of clinical outcomes, little is known about the postoperative HRQoL of patients, especially as regards to degenerative spondylolisthesis

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