Degenerative Spondylolisthesis in Patients With Neurogenic Claudication Effects Functional Performance and Self-Reported Quality of Life

Study Design. The effect of degenerative spondylolisthesis on functional performance and self reported quality of life in patients with lumbar spinal stenosis was compared to patients with lumbar spinal stenosis and no degenerative spondylolisthesis. Objective. To define the relationship degenerative spondylolisthesis shares with functional performance and self reported quality of life in patients with symptomatic lumbar spinal stenosis. Summary of Background Data. Neurogenic claudication is a clinical syndrome that reflects symptoms caused by anatomic spinal stenosis. This condition limits functional status and impacts overall health satisfaction. Degenerative spondylolisthesis is one cause of spinal stenosis and is present to different degrees in patients with neurogenic claudication. Methods. Thirty-eight women and 39 men diagnosed with lumbar spinal stenosis and neurogenic claudication were prospectively enrolled in the study. All underwent routine, screening side-lying, lateral flexion and extension radiographs. The evaluation included a shuttle walking test, as well as patient self-assessment using the Swiss Spinal Stenosis Questionnaire, and Short Form 36. Results. The overall walking distance did not differ based on the presence of degenerative spondylolisthesis. No correlation between magnitude of deformity and decreased walking distance was identified. Men walked on average 231.3 m (SD: 159.2) and women walked 251.3 m ( SD: 138.4). No statistical difference was noted between men and women and their walking ability ( P < 0.56). The Swiss Spinal Stenosis Questionnaire and the Short Form 36 were both strongly correlated with decreased walking ability ( P < 0.05). Conclusion. The presence and magnitude of degenerative spondylolisthesis does not correlate with decreased functional capacity. The Swiss Spinal Stenosis Questionnaire and Short Form 36 are accurate in defining the functional status of a patient. Comprehensive evaluation of patients with symptomatic lumbar spinal stenosis using functional assessment and self-assessment questionnaires are helpful in determining the severity of a patient's disability. Plain radiographs may be valuable adjuncts for surgical decision-making, but are not useful in quantifying the degree to which a patient is impaired.