Surgical vs. conservative care for cervical spondylolisthesis: Which is better for young patients?

Spine

Which is better for cervical spondylolisthesis: surgical treatment with direct repair or conservative treatment?

A study published in The Spine Journal compares the two treatment methods. There were 1,789 patients with low back pain considered, and 149 young patients with spondylolisthesis who followed up for at least one year included in the study. There were 87 patients who underwent conservative treatment and 62 patients who underwent surgery.

 

The researchers found:

 

1. The lower back pain intensity was similar between the two groups at the final follow-up.

 

2. The average ODI and SF-12 scores were similar between the two groups:

 

• ODI — 0.13
• SF-12 PCS — 0.71
• SF-12 MCS — 0.68

 

3. There was a significant change in the gap distance of the pars defect at the final follow-up. The patients in the conservative care group had +0.8±0.4mm while the surgery group reported -0.7±0.5mm.

 

4. At one year after surgery, the union rate was 52 percent among the patients who underwent surgery.

 

5. The complication rate was higher in the surgery group. The complication rate in the surgical group was 31 percent, compared with the conservative care group, which was 20 percent.

 

"Conservative treatment for young patients with spondylolisthesis may produce similar clinical outcomes and fewer complications over 12-month follow-up than surgical treatment with DR," concluded the study authors.

 

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