Risk factors of postoperative low back pain for low-grade isthmic spondylolisthesis: a retrospective study

J Int Med Res. 2020 Mar;48(3):300060519890791. doi: 10.1177/0300060519890791. Epub 2019 Dec 18.

Abstract

Objective: To investigate the risk factors of postoperative low back pain (LBP) following posterior lumbar interbody fusion (PLIF) surgery for low-grade isthmic spondylolisthesis (IS).

Methods: This retrospective study enrolled patients with IS that underwent PLIF between January 2011 and January 2016. Demographic, clinical, surgical and radiological characteristics were analysed to determine associations between these characteristics and LBP as measured using a visual analogue scale (VAS) pain score.

Results: A total of 192 patients were enrolled in the study. The mean VAS pain score of LBP decreased significantly after surgery. The mean preoperative VAS pain score was significantly greater in patients with symptoms of ≤3 years duration compared with those with symptoms lasting >3 years. The postoperative VAS pain score was significantly lower in patients with grade 1 slippage compared with those with grade 2 slippage. There was a significant correlation between preoperative to postoperative change of VAS pain score and postoperative disc height (r = 0.99).

Conclusion: PLIF significantly improved LBP in patients with low-grade IS, although patients still reported some postoperative LBP. The grade of slippage was a risk factor for postoperative LBP. Restoring the disc height appeared to improve LBP.

Keywords: Low-grade isthmic spondylolisthesis; postoperative low back pain; risk factor.

MeSH terms

  • Humans
  • Low Back Pain* / diagnostic imaging
  • Low Back Pain* / etiology
  • Low Back Pain* / surgery
  • Lumbar Vertebrae / diagnostic imaging
  • Lumbar Vertebrae / surgery
  • Retrospective Studies
  • Risk Factors
  • Spinal Fusion* / adverse effects
  • Spondylolisthesis* / diagnostic imaging
  • Spondylolisthesis* / surgery
  • Treatment Outcome