Pain and Quality of Life in Patients Undergoing Lumbar Arthrodesis for Degenerative Spondylolisthesis: A Systematic Review

Alice Maria Santagostino; Delia Cannizzaro; Fanny Soekeland; Stefano Mancin; Beatrice Mazzoleni

doi:10.1016/j.wneu.2023.06.047

Pain and Quality of Life in Patients Undergoing Lumbar Arthrodesis for Degenerative Spondylolisthesis: A Systematic Review

World Neurosurg. 2023 Jun 20:S1878-8750(23)00816-1. doi: 10.1016/j.wneu.2023.06.047. Online ahead of print.

Authors

Alice Maria Santagostino¹, Delia Cannizzaro², Fanny Soekeland³, Stefano Mancin⁴, Beatrice Mazzoleni⁵

Affiliations

¹ Department of Neurology, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy.
² Department of Neurosurgery, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.
³ University of Applied Sciences, School of Health Professions, Bern, Switzerland.
⁴ Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy; Cancer Center, Clinical Nutrition Unit, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy; Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy. Electronic address: Stefano.mancin@humanitas.it.
⁵ Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.

PMID: 37348603
DOI: 10.1016/j.wneu.2023.06.047

Abstract

Background: Degenerative spondylolisthesis is a disease characterized by the displacement of a vertebra above the underlying vertebra. Lumbar arthrodesis is currently the most frequently performed surgical option for treatment due to the use of various approaches and techniques. The disease is characterized by low back pain, a clinical and public health problem, which in addition to having a socio-economic burden, severely affects functional status, quality of life (QoL), activity impairment, and health services. The study aims to investigate the benefits, in terms of pain, disability, andQoL, of lumbar arthrodesis surgery in patients with degenerative spondylolisthesis, at the latest follow-up.

Methods: A systematic literature review registered in PROSPERO (ID: CRD42022379242), was conducted in the databases of: Cochrane Library, PubMed, Embase, Scopus, and Web of Science. The key words used were as follows: "spondylolisthesis", "arthrodesis", "degenerative", "quality of life", "pain", "patient reported outcome", and "disability".

Results: A total of 26 articles were included. Significant differences were found between the preoperative and postoperative evaluation of the outcomes considered, in particular: pain (MD = -6.74; SD = 2.83; 95% CI: -8.01 to -5.46), low back pain (MD = -3.35; SD = 3.27; 95% CI: -3.61 to -3.10), lower limb pain (MD = -3.81; SD = 3.80; 95% CI: -4.10 to -3.51), disability (MD = -23.75; SD = 19.68; 95% CI: -25.26 to -22.23) and QoL (MD = 0.21; SD = 0.24; 95% CI: 0.19 to 0.23).

Conclusions: The results show significant improvement in all measured variables, demonstrating that there are different surgical treatments to cure degenerative spondylolisthesis. However, residual pain impacting the QoL remains, regardless of the technique used. Therefore, the development of personalized pain management for patients with residual chronic pain is indicated.

Keywords: Arthrodesis; Degenerative spondylolisthesis; Disability; Low back pain; Pain; Patient-reported outcome; Quality of life.

Publication types

Review