Universität zu Köln

Wegmann, K., Gundermann, S., Siewe, J., Eysel, P., Delank, K. -S. and Sobottke, R. (2013). Correlation of reduction and clinical outcome in patients with degenerative spondylolisthesis. Arch. Orthop. Trauma Surg., 133 (12). S. 1639 - 1645. NEW YORK: SPRINGER. ISSN 1434-3916

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Abstract

Prospective cohort study. Operative treatment is increasingly implemented for the treatment of degenerative lumbar listhesis, with lumbar fusion the most common intervention. Prediction of clinical outcomes after such procedures is of ongoing relevance, and the correlation of radiologic parameters with clinical outcome remains controversial. In particular, clinical studies have not determined conclusively whether reduction of slipped vertebrae is beneficial. We performed a monocenter prospective analysis of a comprehensive set of quality of life scores (QLS) (Core Outcome Measure Index, Oswestry Low Back Pain Disability Index, SF-36) of 40 patients, who underwent a standardized PLIF procedure for symptomatic, Spondylolisthesis. Follow-up was 24 months. The correlations between the radiologic parameters (degree of slippage, sagittal rotation) and the clinical scores before surgery as well as 12 and 24 months post-operatively were examined. All QLS showed a statistically significant improvement after 12 and 24 months post-operatively (p < 0.05). The mean amount of the anterior slippage was 34.2 +/- A 14.7 % (minimum 12 %, maximum 78 %). After 12 months, there was an average 19.1 % decrease to 15.1 +/- A 8.3 % (minimum 2 %, maximum 38 %, p < 0.000) and after 24 months it was decreased by 18.0-16.2 +/- A 9.0 % (minimum 2.9 %, maximum 40 %, p < 0.000). Average sagittal rotation measured 67.3A degrees A A +/- A 16.6A degrees initially (minimum 35A degrees, maximum 118) and decreased by 4.3A degrees to an average of 63.0A degrees A A +/- A 15.2A degrees at 12 months post-surgery (minimum 15A degrees, maximum 101A degrees, p = 0.065,), and by 5.7A degrees to an average of 61.6A degrees A A +/- A 13.0A degrees at 24 months (minimum 15A degrees, maximum 90A degrees, p = 0.044). The data show positive correlations between the amount of reduction of the slipped vertebra as well as the amount of correction of the sagittal rotation and the improvement of the clinical outcomes(r = 0.31-0.54, p < 0.05). The current study indicates a modest advantage for the best possible reposition in respect of the clinical outcome.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Wegmann, K. UNSPECIFIED UNSPECIFIED UNSPECIFIED Gundermann, S. UNSPECIFIED UNSPECIFIED UNSPECIFIED Siewe, J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Eysel, P. UNSPECIFIED UNSPECIFIED UNSPECIFIED Delank, K. -S. UNSPECIFIED UNSPECIFIED UNSPECIFIED Sobottke, R. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-471134
DOI:	10.1007/s00402-013-1857-8
Journal or Publication Title:	Arch. Orthop. Trauma Surg.
Volume:	133
Number:	12
Page Range:	S. 1639 - 1645
Date:	2013
Publisher:	SPRINGER
Place of Publication:	NEW YORK
ISSN:	1434-3916
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language SAGITTAL BALANCE; MEASURES INDEX; SPINE SURGERY; FUSION; ORIENTATION; DIFFERENCE; CHILDREN; QUALITY Multiple languages Orthopedics; Surgery Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/47113