Wednesday, September 26, 2018 10:35 AM – 12:00 PM Understanding Lumbar Stenosis/Spondylolisthesis: 8. Patient-reported outcomes using ODI, VAS back and leg pain, and PROMIS in low-grade degenerative lumbar spondylolisthesis patients with high versus low pelvic incidence

Abstract

BACKGROUND CONTEXT When evaluating and treating degenerative lumbar spondylolisthesis (DLS) patients, surgeons often do not think about and measure spino-pelvic parameters (SPPs) like they do for spinal deformity and isthmic spondylolisthesis patients. Few studies have looked at the association between patient-reported outcomes (PROs) such as those from Patient-Reported Outcomes Measurement Information System (PROMIS) and SPPs in the low-grade DLS population. A recent study showed an association between global sagittal imbalance and poor PROs in these patients. PURPOSE We aimed to determine if there is an association between PROs and pelvic incidence (PI) in low-grade DLS patients undergoing 1-2 level decompression and fusion. STUDY DESIGN/SETTING Retrospective cohort study, single institution. OUTCOME MEASURES Oswestry Disability Index (ODI), Visual Analog Scale (VAS) Back and Leg Pain. Patient-Reported Outcomes Measurement Information System (PROMIS) Computer Adaptive Tests (CAT) for physical function (PF), pain, depression and anxiety. All measured at baseline, initial, 6-month and 1-year follow-up. METHODS All Myerding grade 1 or 2 DLS patients who underwent 1-2 level decompression and fusion with at least 1-year of follow-up at our institution from August 2015 to October 2017 were retrospectively identified. Patients with high PI (>55°) and low PI ( RESULTS Fifty-nine patients were included with 44 (74.6%) high PI and 15 (25.4%) low PI. Demographics, comorbidities, surgical factors, postoperative complications, fusion status, PI-LL mismatch, and PRO measures were not significantly different (p>0.05) between the groups. In high PI patients, all PRO measures significantly improved (p≤0.05) after surgery compared to baseline at each follow-up. In low PI patients, VAS Back and Leg Pain and PROMIS PF and Pain significantly improved at initial follow-up, PROMIS Pain significantly improved at 6-month follow-up, and ODI, VAS Leg Pain and PROMIS PF and Pain significantly improved at 1-year follow-up. CONCLUSIONS PI does not make a significant difference in PROs in low-grade DLS patients undergoing 1-2 level decompression and fusion. High PI patients significantly improved in all PRO measures after surgery. Low PI patients either significantly improved or trended toward improvement in all PRO measures after surgery. FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs.