THE IMPACT OF MICROENDOSCOPIC DECOMPRESSION ON LOW BACK PAIN IN PATIENTS WITH DEGENERATIVE LUMBAR SPONDYLOLISTHESIS

Abstract

The same surgeon used microendoscopic decompression (MED) for all 70 patients with degenerative lumbar spondylolisthesis (DS). During the same period, fusion was not performed. Clinical outcomes were evaluated by the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ) and visual analogue scale (VAS). Standing maximal flexion-extension lateral radiographs were obtained before and after MED to measure the intervertebral angles and percentages of slipping. The mean duration of follow-up was 47.5 months. The effectiveness rate of low back pain (LBP) was the highest among all five functional scores of the JOABPEQ. LBP, pain and numbness in the buttocks and lower limb as measured by the VAS were significantly improved on follow-up evaluation. Improvements in LBP were significantly correlated with improvements in all other functional scores of the JOABPEQ and with improvements in pain and numbness in the buttocks and lower limb scores of the VAS. However, neither spondylolisthesis nor motion on flexion/ extension (MFE) before and after MED influenced the improvement in LBP and the LBP after MED. The presence of LBP before MED did not lead to poor outcomes. Residual LBP was not related to residual spondylolisthesis or MFE or the development of increased spondylolisthesis postoperatively; however, residual LBP was significantly related to other residual disturbances.