Höggradig kotglidning hos unga patienter
Långtidsresultat efter fusion in situ
av
Anders Joelson
Akademisk avhandling
Avhandling för medicine doktorsexamen som kommer att försvaras offentligt fredagen den 14:e februari 2020 kl. 9.00, Örebro universitet, Campus USÖ, hörsal C3.
Fakultetsopponent: Professor Hans Tropp, Institutionen för klinisk och experimentell medicin, Linköpings universitet.
Örebro universitet
Institutionen för medicinska vetenskaper Örebro 2020
Abstract
Joelson A. (2020). High-grade spondylolisthesis in young patients: Long-term results of in situ fusion. Örebro studies in medicine 205. The purpose of this long-term follow-up of 38 of 40 consecutive patients was to evaluate the results of uninstrumented in situ fusion for high-grade isthmic spondylolisthesis three decades after surgery. The mean age at surgery was 14 (range 9-24) years. The first of four studies evalu-ated clinical outcome, function, work status, and health-relevalu-ated quality of life (HRQoL) after in situ fusion in relation to age-matched Swedish population data. The second study evaluated effects on sagittal balance after in situ fusion. The third study evaluated adjacent segment disk degeneration after in situ fusion. The fourth study evaluated self-image and HRQoL after in situ fusion in relation to healthy controls.
The main findings were that (1) young patients fused in situ for high-grade isthmic spondylolisthesis have long-term HRQoL similar to the general Swedish population and controls matched for age and gender, (2) signs of non-compensated sagittal imbalance were observed only in a few individuals whereas compensated sagittal balance was the norm, (3) there was no correlation between any radiographic sagittal balance parameter and HRQoL outcome, (4) there was only a minor reduction in adjacent segment disk height which had no impact on HRQoL outcome, and (5) the only patient reported outcome measure indicating a detri-mental effect at long-term follow-up was self-assessed trunk appearance which was slightly negatively affected.
Keywords: Adjacent segment disk degeneration, Fusion in situ, Health-related quality of life, Sagittal balance, Self-image, Spondylolisthesis. Anders Joelson, Örebro University School of Medical Sciences, SE-701 82 Örebro, Sweden.
© 2020 Anders Joelson
