J Med Assoc Thai 2016; 99 (6):82

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Comparison of Quality-of-Life after the Three Different Techniques of Transpedicular Screw Fixation (TPSF) in Lumbar Spondylolisthesis (LS): Results of a Therapeutic Cohort Study
Sitthimongkon U Mail, Tangviriyapaiboon T , Iampreechakul P , Veerasan K , Punjaisee S , Tirakotai W

Background: Transpedicular screw fixation in lumbar spondylolisthesis remains debatable for which aspects that provide better quality of life outcomes such as procedure of convention, navigation-assisted or mini-open technique.
Objective: To analyze the clinical outcomes and assess pre-operative versus postoperative quality-of-life outcomes of patients diagnosed with LS who underwent three different techniques of spinal fusion.
Material and Method: A prospective cohort study was conducted with 60 patients with LS who received conventional TPSF or navigation-assisted TPSF or mini-open TPSF at Prasat Neurological Institute between 2010 and 2012. The 12-month follow-up patients were recruited for a structured interview regarding social life, mental health, functional capacity or an independent living status. The quality-of-life measurement was determined using Oswestry Disability Index (ODI) and the Short Form-36 Health Survey (SF-36).
Results: Comparisons of quality of life outcomes declared significant differences through the 12-month follow-up evaluation. According to ODI, navigation-assisted group presented with significant level of faster recovery than conventional and miniopen groups at one week (p = 0.031) and one month (p = 0.008) after surgery. At one year follow-up, the navigation-assisted technique was noted to have a significant better improvement (p = 0.033 and mean ODI scores = 5.8) compared with conventional and mini-open techniques (mean ODI scores = 8.7 and 10.6, respectively). Moreover, SF36 assessment indicated considerably improvement at 12 months after surgery. In addition, the finding reveals no statistically significant
differences among three techniques.
Conclusion: Overall, three different techniques provide the positive outcomes of quality of life. The 12-month follow-up of quality of life measures based on ODI suggest that the navigation-assisted technique was significantly associated with wellrecovered at one week and one month after surgery. However, in terms of clinical outcomes, they do not make any considerable differences to patient care within the 12-month follow-up period.

Keywords: Quality of life, Oswestry Disability Index, Short Form-36 Health Survey, Clinical outcomes, Pedicle screw,
Lumbar spondylolisthesis


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