Outcome of low-grade degenerative spondylolisthesis treated with or without instrumentation

Author(s): Dr. Varun GBS, Dr. Sunil N, Dr. Gurucharan S, Dr. Srikanth EN, Dr. Nagacharan Gowda and Dr. Sumith JM

Abstract: Spondylolisthesis is the anterior translation of cephalad vertebra, in relation to the adjacent caudal vertebra with an intact neural arch. The majority of low-grade listhesis be treated conservatively in the early stages of the disease. In the end, the problem is further compounded by the development of secondary spinal canal stenosis, which leads to the operating room. Therefore, it is necessary to conduct a study to compare the functional and effectiveness of a decompression, with or without instrumentation, for a low-grade, single-level degenerative spondylolisthesis with canal stenosis. Purpose: The study was carried out to compare the functional and clinical outcome of low-grade degenerative spondylolisthesis with a secondary canal stenosis, with or without the instrument. Methods: 40 patients were enrolled and assigned into instrumented or non-instrumented group, 20 patients in each group. The outcome measures were (1) The visual analogue scale to assess the clinical outcome and (2) the Modified Oswestry Disability Index to assess the functional outcome. Results: The improvement in VAS for low back ache was greater in the instrumented group than in the non-instrumented group (91.3% vs 90.5%) with no significant differences (p <0.001) in between the two groups. The improvement in VAS for radiating pain was greater in the non-instrumented group than in the instrumented group (94.9% vs 89.3%; p <0.001). The improvement in ODI was greater in the instrumented group than in the non-instrumented group (69.5% vs 64.6%; p <0.001). Overall outcome was excellent in 70% in instrumented group compared to 35% in the non-instrumented group Conclusions: Functional outcome is higher in the instrumented group & clinical outcome was better for low back ache for patients who underwent instrumentation & for radiating leg pain for patients who underwent non-instrumented procedure. Longer & larger studies may provide a significant outcome. Based on our results & literature review instrumented group is the superior of the two.

DOI: https://doi.org/10.22271/ortho.2021.v7.i3g.2783