A comparison of Decompression and Fusion Surgery in Lumbar Degenerative Spondylolisthesis

ABSTRACT

STUDY DESIGN: A retrospective, controlled study. OBJECTIVES: To assess clinical and radiologic results of decompression without fusion surgery in the treatment of stable lumbar degenerative spondylolisthesis (LDS) and to compare clinical outcomes of fusion surgery. SUMMARY OF LITERATURE REVIEW Although it is reported that decompression surgery is effective in treating LDS, few reports have compared the outcomes of treatment using decompression and instrumented fusion. MATERIALS AND METHODS: A retrospective study was performed and fifty eight degenerative spondylolisthesis patients who received decompression treatment with or without fusion surgery with follow up for at least 2 years were included. The number of patients in the decompression and fusion groups were 23 each and they were selected with age and slip degree taken into account. Clinical factors were evaluated using the Oswestry Disability Index (ODI), Visual Analogue Scale (VAS) of the back/leg and high risk of operation. Radiological factors were evaluated such as slippage, angulation, and disc height at the affected level in preoperative and final follow up. RESULTS: There was no statistical difference between the decompression and fusion groups in the VAS of the back/leg, slippage, and high risk of operation preoperatively (p>0.05). The mean operative time was 73.9 minutes in the decompression group and 123.7 minutes in the fusion group. The mean blood loss was 134.5mL in the decompression group and 323.5mL in the fusion group. VAS of the back/leg and ODI improved in both groups and there were no significant differences between the two groups statistically. CONCLUSIONS: Decompression with/without fusion had a favorable clinical outcome in stable degenerative spondylolisthesis patients. However, fusion involves more operative time and blood loss compared to simple decompression. Simple decompression is a good treatment option, especially in operative high risk patients.