Prospective study of surgical treatment of degenerative spondylolisthesis - Comparison between decompression alone and decompression with Graf systemstabilization

Study Design. A prospective study of patients with degenerative spondylolis thesis who underwent decompression of the spine, with and without stabiliza tion using the Graf system. Objectives. To assess the clinical result of decompression alone and decomp ression using the Graf system. Summary of Background Data. The clinical outcome of lumbar stabilization fo r degenerative spondylolisthesis remains uncertain. There is no prospective study of differences in clinical outcome between patients who undergo deco mpression alone and those who undergo decompression and stabilization using the Graf system. Methods. Eighty-eight patients with degenerative spondylolisthesis were inc luded in this study. All patients reported leg symptoms. Decompression alon e (Group D) was performed in 42 patients during a 5-year period from 1988 t hrough 1992. Decompression and stabilization with the Graf system (Group G) was performed in 46 patients during a 4-year period from 1993 through 1996 . There was no statistical difference regarding sex, the age at operation, compensable cases, and preoperative duration between two groups. The two gr oups were evaluated at follow-up examinations 1 and 3 years after surgery. The clinical results were evaluated for all patients by means of a 4-grade scale, visual analog scale, recurrence of leg symptoms, and persistent low back pain, The radiographic and clinical findings were examined by an indep endent investigator. Results. The results according to the 4-grade scale deteriorated with time in both groups. There was no statistical difference between the two groups in the 4-grade scale, visual analog scale, or recurrence of leg symptoms at each follow-up time. Persistent low back pain in Group G was significantly lower than that in Group D at both the 1- and 3-year follow-ups. Conclusions, Although lumbar Graf stabilization had no effect in preventing the recurrence of leg symptoms, there was a significant effect on reductio n of low back pain at the 1- and 3-year follow-ups.