Comparing Unilateral Versus Bilateral Radiculopathy in Lumbar Degenerative Spondylolisthesis Using ODI Scores. (16th November 2020)

• Record Type: Journal Article
• Authors: Gonzalez, Glenn A; Montenegro, Thiago; Mahtabfar, Aria; Franco, Daniel M; Thalheimer, Sara; Philipp, Lucas R; Al Saiegh, Fadi; Hines, Kevin; Fatema, Umma; Mouchtouris, Nikolaos; Khanna, Omaditya; Hattar, Ellina; Ghosh, Ritam; Stefanelli, Anthony; Sabourin, Victor; Theofanis, Thana N; Ye, Donald Yandong; Atallah, Elias; Andrews, Carrie E; Keppetipola, Kavantissa M; Fitchett, Evan M; Leibold, Adam T; Wu, Chengyuan; Jallo, Jack; Heller, Joshua E; Sharan, Ashwini D; Prasad, Srinivas K; Harrop, James S
• Is Part Of: Neurosurgery. Volume 67(2010)Supplement 1
• Publication Date: 2020-11-16
• Subjects: Nervous system -- Surgery -- Periodicals; 617.48005
• DOI: 10.1093/neuros/nyaa447_788
• Languages: English
• ISSNs: 0148-396X

Abstract

Abstract: INTRODUCTION: Degenerative spondylolisthesis is a disorder that causes the slip of one vertebral body over the one below due to degenerative changes. Degenerative spondylolisthesis regularly occurs in middle-aged or older patients, usually over 50 years of age. METHODS: A prospective quality improvement (QI) hypothesis was constructed, stating that patients who met evidence-based medicine (EBM) criteria would have superior outcomes over patients not meeting criteria. A total of 126 patients with unilateral and bilateral radiculopathy who underwent lumbar fusion surgery met with the inclusion criteria. Also, pre-operative and six-month post-operative ODI scores were collected. Descriptive statistics and student t-test analyses were performed to compared pre-operative and six months ODI change of all patients. Statistical tests were computed at a 95% level of confidence. RESULTS: Pre-operatively and post-operatively (6 months) ODI scores were required for the statistical analysis. A total of 65 patients with degenerative spondylolisthesis presented with unilateral radiculopathy whereas 61 patients had bilateral symptoms. Overall, 87.69%(57/65) of the patients with unilateral symptoms showed improvement in their ODIs. SCB (δODI >10 points) was seen in 40% of the patients, while 61.53% showed MCID (δODI ≥ 5–10 points), and 26.15% evidenced no MCID (δODI < 5 points). In 4.61% of cases, ODI stayed the same, and 7.69% showed decline. Patients with bilateral symptoms showed an overall improvement of 73.77%(45/61) in their ODIs. SCB (δODI >10 points) was seen in 37.70% of patients, while 62.29% showed MCID (δODI ≥ 5–10 points), and 11.47% evidenced no MCID (δODI < 5 points). In 4.91% ODI stayed the same and 21.31% showed worsening in their ODI scores. Statistical significance was seen in both groups ( P < .01). CONCLUSION: Approximately 90% of patients with unilateral symptoms who underwent lumbar fusion showed an improvement in their ODIs with 40% showing SCB compared to only 73.77% of patients with bilateral symptoms. Patients with unilateral radiculopathy seem to do better than those with bilateral radiculopathy.