TY - JOUR
T1 - Preoperative factors affecting the two-year postoperative patient-reported outcome in single-level lumbar grade I degenerative spondylolisthesis
AU - Kanchiku, Tsukasa
AU - Taguchi, Toshihiko
AU - Sekiguchi, Miho
AU - Toda, Naofumi
AU - Hosono, Noboru
AU - Matsumoto, Morio
AU - Tanaka, Nobuhiro
AU - Akeda, Koji
AU - Hashizume, Hiroshi
AU - Kanayama, Masahiro
AU - Orita, Sumihisa
AU - Takeuchi, Daisaku
AU - Kawakami, Mamoru
AU - Fukui, Mitsuru
AU - Kanamori, Masahiko
AU - Wada, Eiji
AU - Kato, So
AU - Hongo, Michio
AU - Ando, Kei
AU - Iizuka, Yoichi
AU - Ikegami, Shota
AU - Kawamura, Naohiro
AU - Takami, Masanari
AU - Yamato, Yu
AU - Takahashi, Shinji
AU - Watanabe, Kei
AU - Takahashi, Jun
AU - Konno, Shinichi
AU - Chikuda, Hirotaka
N1 - Publisher Copyright:
© 2023 The Author(s)
PY - 2023/12
Y1 - 2023/12
N2 - Background: The choice of operative method for lumbar spinal stenosis with Meyerding grade I degenerative spondylolisthesis remains controversial. The purpose of this study was to identify the preoperative factors affecting the 2-year postoperative patient-reported outcome in Meyerding grade I degenerative spondylolisthesis. Methods: Seventy-two consecutive patients who had minimally invasive decompression alone (D group; 28) or with fusion (DF group; 44) were enrolled. The parameters investigated were the Japanese Orthopaedic Association back pain evaluation questionnaire as patient-reported assessment, and L4 slippage (L4S), lumbar lordosis (LL), and lumbar axis sacral distance (LASD) as an index of sagittal alignment for radiological evaluation. Data collected prospectively at 2 years postoperatively were examined by statistical analysis. Results: Sixty-two cases (D group; 25, DF group; 37) were finally evaluated. In multiple logistic regression analysis, preoperative L4S and LASD were extracted as significant preoperative factors affecting the 2-year postoperative outcome. Patients with preoperative L4S of 6 mm or more have a lower rate of improvement in lumbar spine dysfunction due to low back pain (risk ratio=0.188, p=.043). Patients with a preoperative LASD of 30 mm or more have a higher rate of improvement in lumbar dysfunction due to low back pain (risk ratio=11.48, p=.021). The results of multiple logistic analysis by operative method showed that there was a higher rate of improvement in lumbar spine dysfunction due to low back pain in patients with preoperative LASD of 30 mm or more in DF group (risk ratio=172.028, p=.01). Conclusions: Preoperative L4S and LASD were extracted as significant preoperative factors affecting patient-reported outcomes at 2 years postoperatively. Multiple logistic analyses by the operative method suggested that DF may be advantageous in improving lumbar dysfunction due to low back pain in patients with preoperative LASD of 30 mm or more.
AB - Background: The choice of operative method for lumbar spinal stenosis with Meyerding grade I degenerative spondylolisthesis remains controversial. The purpose of this study was to identify the preoperative factors affecting the 2-year postoperative patient-reported outcome in Meyerding grade I degenerative spondylolisthesis. Methods: Seventy-two consecutive patients who had minimally invasive decompression alone (D group; 28) or with fusion (DF group; 44) were enrolled. The parameters investigated were the Japanese Orthopaedic Association back pain evaluation questionnaire as patient-reported assessment, and L4 slippage (L4S), lumbar lordosis (LL), and lumbar axis sacral distance (LASD) as an index of sagittal alignment for radiological evaluation. Data collected prospectively at 2 years postoperatively were examined by statistical analysis. Results: Sixty-two cases (D group; 25, DF group; 37) were finally evaluated. In multiple logistic regression analysis, preoperative L4S and LASD were extracted as significant preoperative factors affecting the 2-year postoperative outcome. Patients with preoperative L4S of 6 mm or more have a lower rate of improvement in lumbar spine dysfunction due to low back pain (risk ratio=0.188, p=.043). Patients with a preoperative LASD of 30 mm or more have a higher rate of improvement in lumbar dysfunction due to low back pain (risk ratio=11.48, p=.021). The results of multiple logistic analysis by operative method showed that there was a higher rate of improvement in lumbar spine dysfunction due to low back pain in patients with preoperative LASD of 30 mm or more in DF group (risk ratio=172.028, p=.01). Conclusions: Preoperative L4S and LASD were extracted as significant preoperative factors affecting patient-reported outcomes at 2 years postoperatively. Multiple logistic analyses by the operative method suggested that DF may be advantageous in improving lumbar dysfunction due to low back pain in patients with preoperative LASD of 30 mm or more.
KW - Degenerative spondylolisthesis
KW - Fusion
KW - Lumbar spinal stenosis
KW - Minimally invasive decompression
KW - Patient-reported assessment
KW - Preoperative factors
UR - http://www.scopus.com/inward/record.url?scp=85170641159&partnerID=8YFLogxK
U2 - 10.1016/j.xnsj.2023.100269
DO - 10.1016/j.xnsj.2023.100269
M3 - 学術論文
C2 - 37731461
AN - SCOPUS:85170641159
SN - 2666-5484
VL - 16
JO - North American Spine Society Journal
JF - North American Spine Society Journal
M1 - 100269
ER -