Long-term disability assessment after surgical treatment of low grade spondylolisthesis

The aim of this study was to determine whether assessment of back surgery w ith disability scores is relevant. We also attempted to answer the question of whether this evaluation should be conducted by a surgeon or a medical d octor. This retrospective study analyzes the long-term outcome (average fol low-up 7 years, range: 3-12) of 40 patients (mean age: 46.2 years) treated by posterior surgical decompression, posterolateral arthrodesis, with or wi thout instrumentation, for symptomatic low-grade spondylolisthesis. All pat ients were interviewed postoperatively and examined the same day by an orth opedic surgeon, who was not involved in the patients' treatment, as well as by a medical doctor rehabilitation specialist. Impairment was assessed by a standardized clinical examination and by visual analog scales (VAS) of pa in. Disability was assessed using two scales: the Quebec disability scale a nd the Beaujon scale. Anxiety and depression were assessed with a validated specific questionnaire (HAD). Patient's perceived handicap was assessed on a 100-mm. VAS. Our results show that the scores of the two disability scal es were highly correlated with the patient's overall satisfaction (r = 0.73 and 0.77 for the Quebec scale and the Beaujon scale, respectively). The in traclass correlation coefficient showed very good or excellent correlation between the data collected by the surgeon and the rehabilitation specialist , ranging from 0.8 to 0.97. This finding clearly demonstrates that intervie w by a surgeon who is not involved in the patient's treatment does not infl uence the patient's assessment in terms of impairment, disability, or handi cap. Moreover, our results suggest that disability scales are the most rele vant outcome measures in the assessment of spine surgery.