医学
脊椎滑脱
减压
Oswestry残疾指数
外科
腰痛
腰椎
背痛
四分位间距
优势比
回顾性队列研究
脊柱融合术
内科学
替代医学
病理
作者
Gastón Camino-Willhuber,Lukas Schönnagel,Thomas Caffard,Jiaqi Zhu,Soji Tani,Erika Chiapparelli,Artine Arzani,Jennifer Shue,Roland Duculan,Mariana Bendersky,William D. Zelenty,Gbolabo Sokunbi,Darren R. Lebl,Frank P. Cammisa,Federico P. Girardi,Carol A. Mancuso,Alexander P. Hughes,Andrew A. Sama
出处
期刊:Clinical spine surgery
[Ovid Technologies (Wolters Kluwer)]
日期:2023-08-25
被引量:1
标识
DOI:10.1097/bsd.0000000000001510
摘要
Study Design: Retrospective study of prospective collected data. Objective: To analyze the association between intervertebral vacuum phenomenon (IVP) and clinical parameters in patients with degenerative spondylolisthesis. Summary of Background Data: IVP is a sign of advanced disc degeneration. The correlation between IVP severity and low back pain in patients with degenerative spondylolisthesis has not been previously analyzed. Methods: We retrospectively analyzed patients with degenerative spondylolisthesis who underwent surgery. Vacuum phenomenon was measured on computed tomography scan and classified into mild, moderate, and severe. A lumbar vacuum severity (LVS) scale was developed based on vacuum severity. The associations between IVP at L4/5 and the LVS scale, preoperative and postoperative low back pain, as well as the Oswestry Disability Index was assessed. The association of IVP at L4/5 and the LVS scale and surgical decision-making, defined as decompression alone or decompression and fusion, was assessed through univariable logistic regression analysis. Results: A total of 167 patients (52.7% female) were included in the study. The median age was 69 years (interquartile range 62–72). Overall, 100 (59.9%) patients underwent decompression and fusion and 67 (40.1%) underwent decompression alone. The univariable regression demonstrated a significantly increased odds ratio (OR) for back pain in patients with more severe IVP at L4/5 [OR=1.69 (95% CI 1.12–2.60), P =0.01]. The univariable regressions demonstrated a significantly increased OR for increased disability with more severe L4/L5 IVP [OR=1.90 (95% CI 1.04–3.76), P =0.04] and with an increased LVS scale [OR=1.17 (95% CI 1.02–1.35), P =0.02]. IVP severity of the L4/L5 were associated with higher indication for fusion surgery. Conclusion: Our study showed that in patients with degenerative spondylolisthesis undergoing surgery, the severity of vacuum phenomenon at L4/L5 was associated with greater preoperative back pain and worse Oswestry Disability Index. Patients with severe IVP were more likely to undergo fusion.
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