NONOPERATIVE VERSUS OPERATIVE TREATMENT OF PATIENTS WITH DEGENERATIVE SPONDYLOLISTHESIS

• Autor(a) principal: Corredor,Jose Alfredo
• Data de Publicação: 2016
• Outros Autores: Araújo,Fernando Flores de, Mendonça,Rodrigo Góes de, Foni,Noel Oizerovici, Astur,Nelson, Gotfryd,Alberto Ofenheim, Umeta,Ricardo Shigueaki Galhego, Caffaro,Maria Fernanda Silber, Avanzi,Osmar, Meves,Robert
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Coluna/Columna
• Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1808-18512016000100033
• topic: Visual analog scale; Degenerative spondylolisthesis; Spine fusion; Spinal canal stenosis; SF-36; Surgery; Nonoperative treatment; lumbar spine; Intervertebral disc degeneration.

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 versus 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.