Coluna / Columna v.15, n.1 /2016

ARTIGO ORIGINAL


NONOPERATIVE OPERATIVE TREATMENT OF PATIENTS WITH DEGENERATIVE SPONDYLOLISTHESIS



Jose Alfredo Corredor¹ , Fernando Flores de Araújo¹ , Rodrigo Góes de Mendonça¹ , Noel Oizerovici Foni¹ , Nelson Astur¹ , Alberto Ofenheim Gotfryd¹ , Ricardo Shigueaki Galhego Umeta¹ , Maria Fernanda Silber Caffaro¹ , Osmar Avanzi¹ , Robert Meves¹

1 . Irmandade da Santa Casa de Misericórdia de São Paulo, Medical School and Hospitals, Department of Orthopaedics and Traumatology, São Paulo, SP, Brazil

DOI: http://dx.doi.org/



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ABSTRACT

Objective:
To evaluate clinical and functional results of patients with lumbar degenerative spondylolisthesis treated with operatively or nonoperatively.

Methods:
Patients with degenerative spondylolisthesis treated either nonoperatively or operatively from 2004 to 2014 were selected from databases and a cross-sectional evaluation was performed. Outcome measures included back and leg visual analogue scales (VAS), Fischgrund criteria, Short Form-36 (SF-36) function score, and the modified Oswestry Disability Index (ODI).

Results:
43 patients were evaluated: 20 with nonoperative treatment and 23 with operative treatment. Baseline characteristics were similar without significant differences between groups. Mean follow-up time was 43 months (range 10 - 72) for the nonoperative group and 36 months (range 6-80) for the operative group. Significant statistical difference in favor of operative group were found in back VAS (mean 4 8, p = 0.000), leg VAS (mean 3 versus 6, p = 0.0015), SF-36 function score (mean 77 versus 35, p = 0.000), and ODI (mean 17 versus 46, p = 0.000). On the basis of the Fischgrund criteria, only 10 % of patients reported excellent or good health post nonoperative treatment versus 83% for those treated operatively (p = 0.000).

Conclusion:
In this cross-sectional study, we observed that symptomatic patients with degenerative spondylolisthesis who underwent operative treatment have superior clinical and functional scores compared to those that underwent nonoperative treatment.


Keywords: Visual analog scale,Degenerative spondylolisthesis,Spine fusion,Spinal canal stenosis,SF-36,Surgery,Nonoperative treatment,lumbar spine,Intervertebral disc degeneration.

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