PMID- 34214985 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20230619 IS - 1547-5646 (Electronic) IS - 1547-5646 (Linking) VI - 35 IP - 3 DP - 2021 Jul 2 TI - Factors associated with using an interbody fusion device for low-grade lumbar degenerative versus isthmic spondylolisthesis: a retrospective cohort study. PG - 299-307 LID - 10.3171/2020.11.SPINE201261 [doi] AB - OBJECTIVE: Many studies have utilized a combined cohort of patients with degenerative spondylolisthesis (DS) and isthmic spondylolisthesis (IS) to evaluate indications and outcomes. Intuitively, these are very different populations, and rates, indications, and outcomes may differ. The goal of this study was to compare specific patient characteristics associated with the utilization of a posterior lumbar interbody device between cohorts of patients with DS and IS, as well as to compare rates of interbody device use and patient-rated outcomes at 1 year after surgical treatment. METHODS: The authors included patients who underwent posterior lumbar interbody fusion or instrumented posterolateral fusion for grade I or II DS or IS and had been enrolled in the Canadian Spine Outcomes and Research Network registry from 2009 to 2016. The outcome measures were score on the Oswestry Disability Index, scores for back pain and leg pain on the numeric rating scale, and mental component summary (MCS) score and physical component summary score on the 12-Item Short-Form Health Survey. Descriptive statistics were used to compare spondylolisthesis groups, logistic regression was used to compare interbody device use, and the chi-square test was used to compare the proportions of patients who achieved a minimal clinically important difference (MCID) at 1 year after surgery. RESULTS: In total, 119 patients had IS and 339 had DS. Patients with DS were more commonly women, older, less likely to smoke, and more likely to have neurogenic claudication and comorbidities, whereas patients with IS more commonly had radicular pain, neurological deficits, and worse back pain. Spondylolisthesis was more common at the L4-5 level in patients with DS and at the L5-S1 level in patients with IS. Similar proportions of patients had an interbody device (78.6% of patients with DS vs 82.4% of patients with IS, p = 0.429). Among patients with IS, factors associated with interbody device utilization were BMI >/= 30 kg/m2 and increased baseline leg pain intensity. Factors associated with interbody device utilization in patients with DS were younger age, increased number of total comorbidities, and lower baseline MCS score. For each outcome measure, similar proportions of patients in the surgical treatment and spondylolisthesis groups achieved the MCID at 1 year after surgery. CONCLUSIONS: Although the demographic and patient characteristics associated with interbody device utilization differed between cohorts, similar proportions of patients attained clinically meaningful improvement at 1 year after surgery. FAU - Inculet, Clayton AU - Inculet C AD - 1Division of Orthopaedics, Department of Surgery, Western University/London Health Sciences Centre, London, Ontario. FAU - Urquhart, Jennifer C AU - Urquhart JC AD - 2Lawson Health Research Institute, London, Ontario. FAU - Rasoulinejad, Parham AU - Rasoulinejad P AD - 1Division of Orthopaedics, Department of Surgery, Western University/London Health Sciences Centre, London, Ontario. AD - 2Lawson Health Research Institute, London, Ontario. FAU - Hall, Hamilton AU - Hall H AD - 3Department of Surgery, University of Toronto, Ontario. FAU - Fisher, Charles AU - Fisher C AD - 4Department of Surgery, Vancouver General Hospital/University of British Columbia, Vancouver, British Columbia. FAU - Attabib, Najmedden AU - Attabib N AD - 5Department of Surgery, Canada East Spine Centre, Saint John, New Brunswick. FAU - Thomas, Kenneth AU - Thomas K AD - 6Department of Surgery, University of Calgary, Alberta. FAU - Ahn, Henry AU - Ahn H AD - 3Department of Surgery, University of Toronto, Ontario. FAU - Johnson, Michael AU - Johnson M AD - 7Department of Orthopedics and Neurosurgery, University of Manitoba, Winnipeg, Manitoba. FAU - Glennie, Andrew AU - Glennie A AD - 8Department of Orthopedics and Neurosurgery, Dalhousie University, Halifax, Nova Scotia. FAU - Nataraj, Andrew AU - Nataraj A AD - 11Department of Surgery, University of Alberta, Edmonton, Alberta, Canada. FAU - Christie, Sean D AU - Christie SD AD - 8Department of Orthopedics and Neurosurgery, Dalhousie University, Halifax, Nova Scotia. FAU - Stratton, Alexandra AU - Stratton A AD - 9Department of Surgery, Ottawa University, Ottawa, Ontario. FAU - Yee, Albert AU - Yee A AD - 3Department of Surgery, University of Toronto, Ontario. FAU - Manson, Neil AU - Manson N AD - 5Department of Surgery, Canada East Spine Centre, Saint John, New Brunswick. FAU - Paquet, Jerome AU - Paquet J AD - 10Department of Surgery, Laval University, Quebec City, Quebec; and. FAU - Rampersaud, Y Raja AU - Rampersaud YR AD - 3Department of Surgery, University of Toronto, Ontario. FAU - Bailey, Christopher S AU - Bailey CS AD - 1Division of Orthopaedics, Department of Surgery, Western University/London Health Sciences Centre, London, Ontario. AD - 2Lawson Health Research Institute, London, Ontario. LA - eng PT - Journal Article DEP - 20210702 PL - United States TA - J Neurosurg Spine JT - Journal of neurosurgery. Spine JID - 101223545 SB - IM OTO - NOTNLM OT - degenerative spondylolisthesis OT - interbody device OT - interbody fusion OT - isthmic spondylolisthesis OT - lumbar OT - patient-rated outcomes EDAT- 2021/07/03 06:00 MHDA- 2021/07/03 06:01 CRDT- 2021/07/02 20:31 PHST- 2020/07/09 00:00 [received] PHST- 2020/11/19 00:00 [accepted] PHST- 2021/07/03 06:01 [medline] PHST- 2021/07/03 06:00 [pubmed] PHST- 2021/07/02 20:31 [entrez] AID - 2020.11.SPINE201261 [pii] AID - 10.3171/2020.11.SPINE201261 [doi] PST - epublish SO - J Neurosurg Spine. 2021 Jul 2;35(3):299-307. doi: 10.3171/2020.11.SPINE201261.