Long-Term Outcomes of Fusion vs Non-Fusion Surgeries for Lumbar Spondylolisthesis

Abstract

Objectives: 1). To compare the long-term clinical, radiological, and functional outcomes of fusion and non-fusion surgeries for lumbar spondylolisthesis (LS), focusing on pain relief, disability reduction, and overall effectiveness of each approach.
Methodology: This retrospective study was conducted at Hayatabad Medical Complex, Peshawar, from January to December 2023. A total of 100 patients (50 in the fusion group and 50 in the non-fusion group) were included. Pre- and post-operative pain (VAS for leg and back pain) and disability (ODI) scores were collected at 1, 6, and 12 months after surgery. Statistical analysis was performed using paired t-tests to assess the significance of differences between pre- and post-operative measures.
Results: The mean age of the patients was 10.2 ± 5.1 years, with 51% males and 49% females. The most common management strategies were lumbar drainage (37%) and duraplasty (28%). Tumour resections more frequently required revision surgery (24%) compared to Chiari malformation decompressions. A significant statistical association (p = 0.0286) was observed between surgery type and CSF leak management strategy. Outcomes showed that lumbar drainage had a higher incidence of recurrence (15%) and pseudomeningoceles (5%) compared to duraplasty, which had a 90% success rate in resolving CSF leaks.
Conclusion: Both fusion and non-fusion surgeries led to significant improvements in pain and disability. These results suggest that non-fusion surgery is a viable alternative to fusion for the treatment of LS, providing substantial benefits in terms of pain relief and functional outcomes.
Keywords: Fusion surgery, Lumbar Spondylolisthesis (LS), Non-fusion surgery, Oswestry Disability Index (ODI)
Visual Analog Scale (VAS),