Analysis of the correlation factors of the MCID in healthrelated quality of life score after lumbar spondylolisthesis

ObjectiveTo analyze the related factors of the minimal clinically important difference(MCID) in healthrelated quality of life score after isthmic spondylolisthesis(IS).

MethodsA total of 74 low-grade IS patients treated with transforaminal lumbar interbody fusion (TLIF) internal fixation fusion were investigated, and followed up for 24 to 49 months.The postoperative Oswestry disability index(ODI) improvement >12 scores and visual analogue scale(VAS) score of lower back pain and leg pain improvement >3 scores were defined as the MCID.The patients were divided into MCID group(group A) and no reaching MCID group(group N) according to the improvement scores of the above items.The general data, imaging parameters and postoperative complications were compared between two groups.

ResultsThe proportions of the improvement scores of ODI, VAS back pain and VAS leg pain achieving the MCID were 81.1%, 79.7% and 73.0%, respectively.The differences of the age and sex in different scores of ODI, VAS back pain and VAS leg pain between two groups were not statistically significant(P>0.05).Under the VAS score of low back pain, the difference of operative segment between two groups was not statistically significant(P>0.05), and under the ODI and VAS leg pain score, the difference of operative segment between two groups was statistically significant(P < 0.05).There was no statistical significance in preoperative imaging parameters between two groups(P>0.05).After surgery, the disc height in group A was higher than that in group N(P < 0.05), and the segmental lordosis in group A was lower than that in group N(P < 0.05).Under the ODI score, the segmental lordosis in group A was lower than that in group N(P < 0.05).There was no statistical significance in other imaging parameters between two groups(P>0.05).There was no statistical significance in the incidence of complications between two groups(P>0.05).

ConclusionsFor low-grade IS patients treated with TLIF, The appropriate disc height reconstruction may be more significant than achieving greater segmental lordosis or increasing reduction rate for low-grade IS patients.