Decompression alone noninferior to decompression with instrumented fusion during a two-year period<\/p>\n<\/h3>\n
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THURSDAY, Aug. 5, 2021 (HealthDay News) — For patients undergoing surgery for degenerative lumbar spondylolisthesis, decompression alone is noninferior to decompression with instrumented fusion during a period of two years, according to a study published in the Aug. 5 issue of the New England Journal of Medicine<\/em>.<\/p>\n Ivar M. Austevoll, M.D., Ph.D., from the Kysthospitalet in Hagevik in Bergen, Norway, and colleagues conducted an open-label, noninferiority trial among patients with symptomatic lumbar stenosis who had not responded to conservative management and who had single-level spondylolisthesis of 3 mm or more. Patients were randomly assigned to undergo decompression surgery alone or decompression surgery with instrumented fusion.<\/p>\n The researchers found that from baseline to two years, the mean change in the Oswestry Disability Index (ODI) score was \u00e2\u0088\u009220.6 and \u00e2\u0088\u009221.3 in the decompression-alone and fusion groups, respectively (mean difference, 0.7; 95 percent confidence interval, \u00e2\u0088\u00922.8 to 4.3). In the modified intention-to-treat analysis, 71.4 percent of 133 patients in the decompression-alone group and 72.9 percent of 129 patients in the fusion group had a reduction of at least 30 percent in the ODI score (difference, \u00e2\u0088\u00921.4 percentage points; 95 percent confidence interval, \u00e2\u0088\u009212.2 to 9.4), demonstrating noninferiority. In the per-protocol analysis, 75.5 percent in each group had a reduction of at least 30 percent in the ODI score (difference, 0.0 percentage points; 95 percent confidence interval, \u00e2\u0088\u009211.4 to 11.4), showing noninferiority. Reoperation occurred in 12.5 and 9.1 percent of the decompression-alone and fusion groups, respectively.<\/p>\n “Decompression alone was noninferior to decompression with instrumented fusion at two years of follow-up,” the authors write. “Reoperation occurred somewhat more often in the decompression-alone group.”<\/p>\n Abstract\/Full Text (subscription or payment may be required)<\/a><\/p>\n <\/i><\/p>\n