Resident Physician UT Southwestern Department of Neurological Surgery Dallas, Texas, United States
Disclosure(s):
James Caruso, n/a: No financial relationships to disclose
Introduction: Low-grade degenerative lumbar spondylolisthesis (Meyerding Grades I and II) is a common pathology, and it can result in debilitating back pain, neurologic injury, and functional impairment. Interbody (IB) placement is commonly recommended to facilitate anterior column fusion and restore alignment, but it remains unclear whether IB placement also promotes additional functional improvement.
Methods: Using a prospectively maintained institutional database, consecutive patients who had no prior history of lumbar spine surgery and underwent one- or two-level fusion, with or without IB, for correction of low-grade lumbar spondylolisthesis were identified. Patient-reported outcome measures (PROMS) were obtained preoperatively and at 6 month and 12 month post-operative timepoints. Associations between IB placement and longitudinal PROMs were calculated using repeated measures linear mixed effects models
Results: 105 consecutive patients who met eligibility criteria were included in the analysis. 61 patients underwent fusion with IB, 44 patients underwent posterolateral fusion without IB. Both groups demonstrated significant improvements in ODI, VAS-Back, and VAS-Leg scores at 6 months after surgery compared to baseline, but interbody placement did not result in greater degrees of improvement in these measures (p = 0.66, p = 0.85, and p = 0.46, respectively). Similar trends were noted for PROMIS-29 pain interference, physical function, pain intensity, and satisfaction with participation in social roles. There were no significant differences across timepoints in either group in PROMIS-29 anxiety, depression, fatigue, or sleep disturbance scores.
Conclusion : Interbody fusion does not provide superior functional benefit for patients with low-grade spondylolisthesis when compared to posterolateral fusion alone.
