Severe Intervertebral Vacuum Phenomenon is Associated With Higher Preoperative Low Back Pain, ODI, and Indication for Fusion in Patients With Degenerative Lumbar Spondylolisthesis
Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved..
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.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:37 |
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| Enthalten in: |
Clinical spine surgery - 37(2024), 1 vom: 01. Feb., Seite E1-E8 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Camino-Willhuber, Gaston [VerfasserIn] |
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| Anmerkungen: |
Date Completed 30.01.2024 Date Revised 16.04.2024 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1097/BSD.0000000000001510 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM361493878 |
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| 100 | 1 | |a Camino-Willhuber, Gaston |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Severe Intervertebral Vacuum Phenomenon is Associated With Higher Preoperative Low Back Pain, ODI, and Indication for Fusion in Patients With Degenerative Lumbar Spondylolisthesis |
| 264 | 1 | |c 2024 | |
| 336 | |a Text |b txt |2 rdacontent | ||
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| 500 | |a Date Completed 30.01.2024 | ||
| 500 | |a Date Revised 16.04.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved. | ||
| 520 | |a STUDY DESIGN: Retrospective study of prospective collected data | ||
| 520 | |a OBJECTIVE: To analyze the association between intervertebral vacuum phenomenon (IVP) and clinical parameters in patients with degenerative spondylolisthesis | ||
| 520 | |a 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 | ||
| 520 | |a 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 | ||
| 520 | |a 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 | ||
| 520 | |a 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 | ||
| 650 | 4 | |a Journal Article | |
| 700 | 1 | |a Schönnagel, Lukas |e verfasserin |4 aut | |
| 700 | 1 | |a Caffard, Thomas |e verfasserin |4 aut | |
| 700 | 1 | |a Zhu, Jiaqi |e verfasserin |4 aut | |
| 700 | 1 | |a Tani, Soji |e verfasserin |4 aut | |
| 700 | 1 | |a Chiapparelli, Erika |e verfasserin |4 aut | |
| 700 | 1 | |a Arzani, Artine |e verfasserin |4 aut | |
| 700 | 1 | |a Shue, Jennifer |e verfasserin |4 aut | |
| 700 | 1 | |a Duculan, Roland |e verfasserin |4 aut | |
| 700 | 1 | |a Bendersky, Mariana |e verfasserin |4 aut | |
| 700 | 1 | |a Zelenty, William D |e verfasserin |4 aut | |
| 700 | 1 | |a Sokunbi, Gbolabo |e verfasserin |4 aut | |
| 700 | 1 | |a Lebl, Darren R |e verfasserin |4 aut | |
| 700 | 1 | |a Cammisa, Frank P |e verfasserin |4 aut | |
| 700 | 1 | |a Girardi, Federico P |e verfasserin |4 aut | |
| 700 | 1 | |a Mancuso, Carol A |e verfasserin |4 aut | |
| 700 | 1 | |a Hughes, Alexander P |e verfasserin |4 aut | |
| 700 | 1 | |a Sama, Andrew A |e verfasserin |4 aut | |
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