644 - Comparison of Outcomes for Lumbar Fusion in the Treatment of Degenerat...

Oral Posters: MIS

Presented by: G. Lopez - View Audio/Video Presentation (Members Only)

Author(s):

F. Phillips(1), G. Lopez(2), K. Kajavi(3), A. Kanter(4), M. Peterson(5)

(1) Midwest Orthopaedics at Rush University, Spine Surgery, Chicago, IL, United States
(2) Midwest Orthopaedics at Rush University, Spine, Chicago, IL, United States
(3) Georgia Spine and Neurosurgery Institue, Atlanta, GA, United States
(4) University of Pittsburgh, PIttsburgh, PA, United States
(5) Southern Oregon Spine Care, Medford, OR, United States

Abstract

Study Design: Retrospective analysis of a prospectively maintained surgical database.

Objectives: Lumbar fusion for degenerative spondylolisthesis(DSP) is well accepted and has been shown in the literature to have a low complication rate and high clinical efficacy. The role of fusion for the treatment of degenerative disc disease(DDD) remains controversial. The purpose of this study is to report and compare clinical outcomes in patients treated with fusion for DSP or DDD using contemporary fusion techniques from a prospective, multicenter registry. Patients and

Methods: The Society of Lateral Access Surgery database was queried. 632 patients had a primary diagnosis of either DDD or DSP with single level disease between T12-S1. Of those, 100 of these patients had a minimum of two year clinical follow up without prior surgery at the index or adjacent levels. Oswestry disability index scores (ODI), Numeric rating scale (NRS), and the Short form 12/36 (SF12/36) were all taken. Patients were followed up at 6 weeks, 3 months, 6 months, 12 months and 24 months. Frequency analysis and Fishers' exact tests and two-sample t-tests were used for statistical analysis.

Results: In total, there were 34 patients in the DDD group and 66 in the DSP group. Patients with DDD had higher levels of disability at baseline (ODI mean 51 for DDD group, 39.2 for DSP group) and at two years follow up (ODI mean 27.9 for DDD group versus 18.8 for DSP group), but both the DSP and DDD patients had similar magnitudes of improvement from baseline to two years. In both groups, low back pain, leg pain, and SF 12/36 scores were improved at 6 weeks post operatively and plateaued, whereas disability as measured by ODI continued to improve until one year, when it plateaued. In total, 13 patients underwent anterior lumbar interbody fusion, 45 patients underwent posterior fusion, and 42 patients underwent extreme lateral interbody fusion. Procedures did not vary statistically between diagnosis type (p=.3226).

Conclusion: Using contemporary fusion techniques, improvements in pain, disability and outcomes were achieved in properly selected patients with the diagnosis of DDD and DSP out to two years postoperatively.