The Operative Efficacy of Decompression and Fixation Surgery for Degenerative Lumbosacral Spondylolisthesis: A Single Institutional Study

Main Article Content

Aurangzeb Kalhoro
Kashif Ahmed
Abdul Sattar M. Hashim

Abstract

Objective: To assess the results of lumber decompression and lumbar stabilization for spondylolisthesis.


Methodology: A retrospective study was designed and included a record of six years. We included 84 patients with Spondylolisthesis. The Meyerding classification was utilized to classify the extent of vertebral slippage in spondylolisthesis. In the case of spondylolisthesis, we did a decompression and pedicle screw fixation. Z score formula was applied to compare the two preoperative and postoperative outcomes in ODIs and report significant result.


Results: The mean age of the patients in the study was 49.79 ± 8.11 years. There were 48 (57.14%) male patients and 36 (42.85%) female patients. Spondylolisthesis occurred at L3-L4 in 11 (13.1%) cases. Among the patients, 72 (85.7%) had moderate, 8 (9.5%) had severe, and 4 (4.7%) had mild ODI. Postoperatively, 69 (95.8%) patients experienced substantial improvement in ODI.Top of Form


Conclusion: In patients with a mild to moderate Oswestry Disability Index before surgery, the surgical technique provides superior clinical outcomes and improvement.

Article Details

How to Cite
1.
Kalhoro A, Kashif Ahmed, Abdul Sattar M. Hashim. The Operative Efficacy of Decompression and Fixation Surgery for Degenerative Lumbosacral Spondylolisthesis: A Single Institutional Study. J Postgrad Med Inst [Internet]. 2024 Sep. 30 [cited 2024 Dec. 5];38(3). Available from: https://www.jpmi.org.pk/index.php/jpmi/article/view/3358
Section
Original Article
Author Biographies

Aurangzeb Kalhoro, Jinnah Medical and Dental College, Karachi and Neuro Spinal Cancer Care Institute

Assistant professor neurosurgery, Jinnah medical and dental college, Karachi

Kashif Ahmed , Neurospinal Cancer Care Institute, Karachi

FCPS, Neurosurgery Consultant Neurosurgeon, Neuro Spinal & Cancer care Institute, Karachi 

Abdul Sattar M. Hashim , Neurospinal Cancer Care Institute, Karachi

Post: Ex Prof jpmc & Medical director neuro spinal & cancer care institute 

References

Shen Z, Guan X, Wang R, Xue Q, Zhang D, Zong Y, Ma W, Zhuge R, Liu Z, He C, Guo L. Effectiveness and safety of decompression alone versus decompression plus fusion for lumbar spinal stenosis with degenerative spondylolisthesis: a systematic review and meta-analysis. Annals of Translational Medicine. 2022 Jun;10(12). doi: 10.21037/atm-22-2208

Tahir M, Rehman L, Bokhari I, Ahmed SI, Afzal A. Surgical Outcome of Decompression and Fixation of Degenerative Lumbosacral Spondylolisthesis Surgery in Pakistani Population. Cureus. 2019;11(8). DOI: 10.7759/cureus.5493

Rousseau MA, Lazennec JY, Bass EC, Saillant G. Predictors of outcomes after posterior decompression and fusion in degenerative spondylolisthesis. European Spine Journal. 2005;14(1):55-60. DOI:10.1007/s00586-004-0703-7

Smith J. Moving beyond the neutral spine: stabilizing the dancer with lumbar extension dysfunction. Journal of Dance Medicine & Science. 2009;13(3):73-82. https://doi.org/10.1177/1089313X0901300302

Strube P, Putzier M, Siewe J, Eicker SO, Dreimann M, Zippelius T. To fuse or not to fuse: a survey among members of the German Spine Society (DWG) regarding lumbar degenerative spondylolisthesis and spinal stenosis. Archives of orthopaedic and trauma surgery. 2019;139(5):613-21. DOI:10.1007/s00402-018-3096-5

Angachekar D, Deshpande S, Gudhe M, Samal N, Khan S, Gupta S. Clinical and functional outcome analysis of posterior decompression and spinal fusion surgery in the management of lumbar and sacral listhesis: A prospective cohort study. Journal of Datta Meghe Institute of Medical Sciences University. 2020;15(3):407. DOI: 10.4103/jdmimsu.jdmimsu_245_20

ur Rehman R, Iqbal N. Pedicle Screw Fixation with Decompression: The Ultimate Solution for Medically Intractable Spondylolistheses. Ophthalmology Update. 2020;18(4):46-9.

Kawakami M, Tamaki T, Ando M, Yamada H, Hashizume H, Yoshida M. Lumbar sagittal balance influences the clinical outcome after decompression and posterolateral spinal fusion for degenerative lumbar spondylolisthesis. Spine. 2002;27(1):59-64. DOI 10.1097/00007632-200201010-00014

Inose H, Kato T, Yuasa M, Yamada T, Maehara H, Hirai T, Yoshii T, Kawabata S, Okawa A. Comparison of decompression, decompression plus fusion, and decompression plus stabilization for degenerative spondylolisthesis: a prospective, randomized study. Clinical spine surgery. 2018;31(7):E347. doi: 10.1097/BSD.0000000000000659

Sharif S, Shaikh Y, Bajamal AH, Costa F, Zileli M. Fusion Surgery for Lumbar Spinal Stenosis: WFNS Spine Committee Recommendations. World Neurosurgery: X. 2020;7:100077. https://doi.org/10.1016/j.wnsx.2020.100077

Sun W, Xue C, Tang XY, Feng H, Yuan F, Guo KJ, Zhao J. Selective versus multi-segmental decompression and fusion for multi-segment lumbar spinal stenosis with single-segment degenerative spondylolisthesis. Journal of orthopaedic surgery and research. 2019;14(1):1-6. https://doi.org/10.1186/s13018-019-1092-2

Ferrero E, Guigui P. Current trends in the management of degenerative lumbar spondylolisthesis. EFORT open reviews. 2018;3(5):192-9. DOI: https://doi.org/10.1302/2058-5241.3.170050

Heo DH, Jang JW, Lee JK, Park CK. Slippage reduction of lumbar spondylolisthesis using percutaneous pedicle screw with reduction fixation system after interbody fusion: A comparison with traditional open fusion and pedicle screw fixation. Journal of Clinical Neuroscience. 2019;67:156-62. https://doi.org/10.1016/j.jocn.2019.05.040

Ishaq M, Khan M, Ahmed A, Ali G. Surgical Outcome of Transpedicular Fixation for Degenerative Spondylolisthesis in Terms of Relief from Backache. Pakistan Journal Of Neurological Surgery. 2021 16;25(3):406-13. DOI: https://doi.org/10.36552/pjns.v25i3.592

Chan AK, Mummaneni PV, Burke JF, Mayer RR, Bisson EF, Rivera J, Pennicooke B, Fu KM, Park P, Bydon M, Glassman SD. Does reduction of the Meyerding grade correlate with outcomes in patients undergoing decompression and fusion for grade I degenerative lumbar spondylolisthesis?. Journal of Neurosurgery: Spine. 2021;1(aop):1-8. DOI link: https://doi.org/10.3171/2021.3.SPINE202059

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