Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden; Department of Orthopaedics, Karolinska University Hospital, Stockholm, Sweden.
Department of Clinical Science, Karolinska Institutet, Södersjukhuset, Stockholm, Sweden; Department of Orthopaedics, Södersjukhuset, Stockholm, Sweden.
Spine J. 2019 Mar;19(3):501-508. doi: 10.1016/j.spinee.2018.08.008. Epub 2018 Aug 22.
Data on the long-term outcome after fusion for isthmic spondylolisthesis are scarce.
To study patient-reported outcomes and adjacent segment degeneration (ASD) after fusion for isthmic spondylolisthesis and to compare patient-reported outcomes with a control group.
STUDY DESIGN/SETTING: A prospective study including a cross-sectional control group.
Patients with isthmic spondylolisthesis underwent posterior lumbar interbody fusion (PLIF) (n=86) or posterolateral fusion (PLF) (n=77). Patient-reported outcome data were available for 73 patients in the PLIF group and 71 in the PLF group at a mean of 11 (range 5-16) years after baseline. Seventy-seven patients in the PLIF group and 54 in the PLF group had radiographs at a mean of 14 (range 9-19) years after baseline. One hundred thirty-six randomly selected persons from the population served as controls for the patient-reported outcomes.
Patient-reported outcomes include the following: global outcome, Oswestry Disability Index, Disability Rating Index, and Short Form 36. The ASD was determined from radiographs using the University of California Los Angeles (UCLA) grading scale.
The chi-square test or analysis of covariance (ANCOVA) was used for group comparisons. The ANCOVA was adjusted for follow-up time, smoking, Meyerding slippage grade, teetotaler (yes/no) and, if available, the baseline level of the dependent variable.
There were no significant patient-reported outcome differences between the PLIF group and the PLF group. The prevalence of ASD was 42% (32/77) in the PLIF group and 26% (14/54) in the PLF group (p=.98). The patient-reported outcome data indicated lower physical function and more pain in individuals with surgically treated isthmic spondylolisthesis compared to the controls.
PLIF and PLF groups had similar long-term patient-reported and radiological outcomes. Individuals with isthmic spondylolisthesis have lower physical function and more pain several years after surgery when compared to the general population.
关于峡部裂性脊柱滑脱融合术后长期疗效的数据很少。
研究峡部裂性脊柱滑脱融合术后患者报告的结果和邻近节段退变（ASD），并将患者报告的结果与对照组进行比较。
研究设计/设置：一项包括横断面对照组的前瞻性研究。
接受后路腰椎间融合术（PLIF）（n=86）或后路外侧融合术（PLF）（n=77）的峡部裂性脊柱滑脱患者。PLIF 组中有 73 例患者和 PLF 组中有 71 例患者在基线后 11 年（范围 5-16 年）时获得了患者报告的结果数据。PLIF 组中有 77 例患者和 PLF 组中有 54 例患者在基线后 14 年（范围 9-19 年）时拍摄了 X 线片。从人群中随机选择 136 人作为患者报告结果的对照组。
患者报告的结果包括以下内容：总体结果、Oswestry 残疾指数、残疾评定指数和简短 36 项健康调查量表。使用加利福尼亚大学洛杉矶分校（UCLA）分级标准从 X 线片上确定 ASD。
使用卡方检验或协方差分析（ANCOVA）进行组间比较。ANCOVA 调整了随访时间、吸烟、Meyerding 滑脱程度、是否滴酒不沾（是/否）以及在可用的情况下，依赖变量的基线水平。
PLIF 组和 PLF 组之间患者报告的结果没有显著差异。PLIF 组 ASD 的患病率为 42%（32/77），PLF 组为 26%（14/54）（p=.98）。患者报告的结果数据表明，与对照组相比，接受手术治疗的峡部裂性脊柱滑脱患者的生理功能较低，疼痛较多。
PLIF 和 PLF 组具有相似的长期患者报告和影像学结果。与一般人群相比，患有峡部裂性脊柱滑脱的患者在手术后数年生理功能较低，疼痛较多。
