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Greater improvement in QoL seen after laminectomy with fusion vs laminectomy alone
Investigators of this randomized controlled trial found laminectomy performed in addition to lumbar spinal fusion was linked with slightly better, but clinically meaningful improvement in the overall physical health-related quality of life of patients with degenerative spondylolisthesis compared to treatment with laminectomy alone.
Researchers evaluated patients with stable degenerative spondylolisthesis and symptoms of lumbar spinal stenosis and randomly assigned 28 patients to undergo laminectomy with posterolateral fusion and 33 patients to underdo decompressive laminectomy alone. Patients were followed for 4 years. At 2 years postoperatively, investigators evaluated the change in the SF-36 physical-component summary score. They also measured patients’ Oswestry Disability Index (ODI) scores. Surgical complications and reoperations were also determined during clinical evaluations.
Zoher Ghogawala
Results showed the follow-up rate at 1 year, 2 years and 4 years was 89%, 86% and 68%, respectively. Investigators noted after 2 years postoperatively, patients who underwent fusion had a greater increase in SF-36 physical-component summary scores compared with patients who underwent decompression alone and their scores remained greater than the decompression alone group at both the 3-year and 4-year follow-up.
According to researchers, groups were not significantly different with regard to ODI scores after 2 years. Patients who underwent fusion had greater blood loss and longer hospital stays compared with patients who underwent decompression alone. The fusion group had a 14% reoperation rate, and the decompression-alone group had a 34% reoperation rate. ‒ by Monica Jaramillo
Disclosures: The study was supported by research grants from the Jean and David Wallace Foundation (GH 382) and the Greenwich Lumbar Stenosis SLIP Study Fund (GH 384), which was established by Lucinda B. Watson with support from the Stephanie and Lawrence Flinn Jr. Charitable Trust and James and Elizabeth Li, and by Alan and Jacqueline Stuart, who provided funds to create a Spine Outcomes Research Center at Lahey Hospital and Medical Center to
complete the analysis of the SLIP trial results.