Patient outcomes after decompression and instrumented posterior spinal fusion for degenerative spondylolisthesis

被引:79
作者
Nork, SE [1 ]
Hu, SS [1 ]
Workman, KL [1 ]
Glazer, PA [1 ]
Bradford, DS [1 ]
机构
[1] Univ Calif San Francisco, Dept Orthopaed Surg, San Francisco, CA 94143 USA
关键词
D O I
10.1097/00007632-199903150-00012
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Study Design. A retrospective study of patient outcomes after decompression and fusion for degenerative spondylolisthesis, using the SF-36 survey and a functional questionnaire. Summary of Background Data. In recent studies, patient outcomes have been examined more specifically; however, detailed functional outcomes are not available nor have widely used outcomes instruments have administered. Methods. 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. 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 medicated usage (P < 0.0001). SF-36 data showed significantly better over-all 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). Conclusions. 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.
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页码:561 / 569
页数:9
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共 41 条
  • [1] VALIDATING THE SF-36 HEALTH SURVEY QUESTIONNAIRE - NEW OUTCOME MEASURE FOR PRIMARY CARE
    BRAZIER, JE
    HARPER, R
    JONES, NMB
    OCATHAIN, A
    THOMAS, KJ
    USHERWOOD, T
    WESTLAKE, L
    [J]. BMJ-BRITISH MEDICAL JOURNAL, 1992, 305 (6846): : 160 - 164
  • [2] THE ROLE OF FUSION AND INSTRUMENTATION IN THE TREATMENT OF DEGENERATIVE SPONDYLOLISTHESIS WITH SPINAL STENOSIS
    BRIDWELL, KH
    SEDGEWICK, TA
    OBRIEN, MF
    LENKE, LG
    BALDUS, C
    [J]. JOURNAL OF SPINAL DISORDERS, 1993, 6 (06): : 461 - 472
  • [3] Carpenter CT, 1996, J BONE JOINT SURG AM, V78A, P712
  • [4] DEYO RA, 1993, SPINE, V18, P1463
  • [5] RESULTS OF OPERATIVE TREATMENT OF IDIOPATHIC SCOLIOSIS IN ADULTS
    DICKSON, JH
    MIRKOVIC, S
    NOBLE, PC
    NALTY, T
    ERWIN, WD
    [J]. JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME, 1995, 77A (04) : 513 - 523
  • [6] DEGENERATIVE SPONDYLOLISTHESIS - TO FUSE OR NOT TO FUSE
    FEFFER, HL
    WIESEL, SW
    CUCKLER, JM
    ROTHMAN, RH
    [J]. SPINE, 1985, 10 (03) : 287 - 289
  • [7] 1997 Volvo Award winner in clinical studies - Degenerative lumbar spondylolisthesis with spinal stenosis: A prospective, randomized study comparing decompressive laminectomy and arthrodesis with and without spinal instrumentation
    Fischgrund, JS
    Mackay, M
    Herkowitz, HN
    Brower, R
    Montgomery, DM
    Kurz, LT
    [J]. SPINE, 1997, 22 (24) : 2807 - 2812
  • [8] THE SF-36 HEALTH SURVEY QUESTIONNAIRE - AN OUTCOME MEASURE SUITABLE FOR ROUTINE USE WITHIN THE NHS
    GARRATT, AM
    RUTA, DA
    ABDALLA, MI
    BUCKINGHAM, JK
    RUSSELL, IT
    [J]. BMJ-BRITISH MEDICAL JOURNAL, 1993, 306 (6890): : 1440 - 1444
  • [9] DEGENERATIVE LUMBAR SPONDYLOLISTHESIS WITH SPINAL STENOSIS - A PROSPECTIVE-STUDY COMPARING DECOMPRESSION WITH DECOMPRESSION AND INTERTRANSVERSE PROCESS ARTHRODESIS
    HERKOWITZ, HN
    KURZ, LT
    [J]. JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME, 1991, 73A (06) : 802 - 808
  • [10] DEGENERATIVE LUMBAR SPONDYLOLISTHESIS
    HERKOWITZ, HN
    [J]. SPINE, 1995, 20 (09) : 1084 - 1090