Abstract

Purpose

The aim of this study is to determine whether there is a relationship between radiographic slip progression and symptomatic worsening after decompression without fusion for low-grade degenerative lumbar spondylolisthesis (DLS).

Methods

A retrospective review of 1–2-level minimally invasive surgical decompression for grade I–II DLS was performed. Included subjects had a minimum of 1-year follow-up with prospectively collected baseline and follow-up Oswestry Disability Index (ODI) scores.

Results

Fifty-six patients (33 females, 58.9%), having a mean age 65.6 years (SD 10.0), met inclusion criteria. Spondylolisthesis slip percentage increased in 55.4% (31/56) of patients. Slip percentage increased significantly (p = 0.002) from baseline (mean 17.2; SD 8.0) to follow-up (mean 20.1; SD 9.6). A logistic regression model identified that females were more likely to have progressive slips compared to males (odd ratio 6.09, 95% CI 1.77–21.01; p = 0.004). ODI scores and spondylolisthesis slip percentage did not correlate at baseline (r = 0.0170; p = 0.90) nor follow-up (r = 0.094; p = 0.49). There was no correlation between the change in ODI scores and change in slip percentage from baseline to final follow-up (r = 0.0474; p = 0.73). Of the 31 patients with slip progression, there was no difference in mean ODI score changes (p = 0.91) for those with 1–5% progression (13/31 [41.9%]; − 18.0 [SD 19.7]) compared to those with > 5% slip progression (18/31 [58.1%]; − 18.7 [SD 16.4]).

Conclusions

Despite a small degree of slip progression in the majority of patients, there was no correlation with symptom worsening, as measured by the ODI.

Graphic abstract

These slides can be retrieved under Electronic Supplementary Material.

中文翻译：

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微创减压手术后退行性腰椎滑脱的滑移进展与功能障碍增加无关

摘要

目的

这项研究的目的是确定低度退行性腰椎滑脱症（DLS）减压无融合后的影像学影像学进展与症状恶化之间是否存在关系。

方法

回顾性回顾了I–II级DLS的1-2级微创手术减压。纳入的受试者至少接受了为期1年的随访，其前瞻性收集的基线和随访的Oswestry残疾指数（ODI）得分。

结果

五十六名患者（33名女性，占58.9％），平均年龄65.6岁（标准差10.0），符合纳入标准。腰椎滑脱的百分比增加了55.4％（31/56）的患者。 从基线（平均值17.2； SD 8.0）到随访（平均值20.1； SD 9.6），滑脱百分比显着增加（p = 0.002）。逻辑回归模型表明，与男性相比，女性更有可能出现进行性滑倒（赔率6.09，95％CI 1.77-21.01；p  = 0.004）。ODI评分和腰椎滑脱率在基线时无相关性（r  = 0.0170；p  = 0.90），也没有随访（r  = 0.094; p = 0.49）。从基线到最终随访，ODI得分的变化与滑动百分比的变化之间没有相关性（r  = 0.0474；p  = 0.73）。在31例进展缓慢的患者中，进展程度 为1–5％的患者（13/31 [41.9％]； − 18.0 [SD 19.7]）的ODI平均得分变化（p = 0.91）没有差异。> 5％的滑移进展（18/31 [58.1％]； − 18.7 [SD 16.4]）。

结论

尽管大多数患者的滑倒进展程度较小，但根据ODI的测量，其与症状恶化无相关性。

图形摘要

这些幻灯片可以在“电子补充材料”下找到。