The researchers examined patients who underwent single-level arthrodesis for L4-L5 degenerative spondylolisthesis. There were 179 patients included in the study who had surgery between 2004 and 2012. There were 68 patients who had posterolateral arthrodesis alone and 111 patients who had the procedure with interbody arthrodesis.
The researchers found:
1. There weren’t any significant differences in these tests at six months:
• Oswestry Disability Index
• 36-item Short-Form Health Survey scores
• Fusion rates
• Cost/value
2. There weren’t any differences between the two groups at three years after surgery either, even though the patients in the posterolateral arthrodesis-only group were significantly older and had more medical comorbidities.
3. When the length of stay was normalized across all of the cohorts, the interbody arthrodesis increased hospital costs by $577 to $5,276; however, this didn’t reach statistical significance.
4. Adding interbody arthrodesis has become more popular over the past 20 years, but the value added isn’t clearly defined.
5. The researchers concluded, “This single-center review of open surgical treatment of L4-L5 DS demonstrated that the addition of IBA to PLA added cost while producing equivalent results for fusion rates, Oswestry Disability Index and 36-item Sort Form Health Survey scores when compared with PLA alone.”
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