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Lumbar spinal fusion plus laminectomy yields improved results over laminectomy alone for degenerative spondylolisthesis

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Patients with degenerative grade I spondylolisthesis with lumbar spinal stenosis may experience improved quality of life after undergoing a laminectomy with lumbar spinal fusion vs. laminectomy alone, according to findings presented at the American Association of Neurological Surgeons Annual Meeting.

According to an American Association of Neurological Surgeons news release, Zoher Ghogawala, MD, and his co-authors conducted a prospective, five-center randomized control trial from 2002 to 2009 wherein 130 patients from 50 years to 80 years of age were randomized to receive either laminectomy alone or laminectomy with posterolateral instrumented fusion.

A total of 106 patients were enrolled with 66 patients being randomized to receive either decompression alone or decompression with surgery. Using a primary outcome measure of SF-36 physical component summary (PCS), the researchers clinically assessed patients at the 1-, 3- and 6-month marks. Patients were then assessed annually by phone for 5 years.

There was a 2-year follow-up rate of 86% and 4-year follow-up rate of 85%. The researchers found surgery to be associated with significant improvements in SF-36 PCS and Oswestry Disability Index scores at each follow-up point. They also found laminectomy with fusion yielded improved SF-36 PCS scores than laminectomy alone at the 6-month, 2-year and 4-year postoperative marks.

Patients who did not undergo fusion had a 35.3% reoperation rate. Fusion added to laminectomy reduced this reoperation rate to 12.9%.

According to the release, the researchers concluded that lumbar spinal fusion in addition to laminectomy for the treatment of degenerative grade I spondylolisthesis was associated with superior SF-36 PCS outcome, resulting in fewer reoperations within 4 years of the procedure.

Reference:

• Ghogawala Z, Benzel E, Butler W, et al. Lumbar spinal fusion plus laminectomy is superior to laminectomy alone for grade I degenerative spondylolisthesis: SLIP study results. Presented at the American Association of Neurological Surgeons Annual Meeting. April 14-18, 2012. Miami.
• Disclosure: The authors have no relevant financial disclosures.