Decompression vs. Fusion for Stable Degenerative Spondylolisthesis
Spinal Stenosis, Spondylolisthesis
About this trial
This is an interventional treatment trial for Spinal Stenosis focused on measuring Pilot projects, Feasibility studies, Intervention studies, Orthopedics, Orthopedic Procedures, Neurosurgical Procedures, Neurosurgery, Spine, Spinal Fusion, Spondylodesis, Spondylosyndesis, Laminectomy, Foraminotomy, Decompression, surgical, Low Back Pain, Quality of Life
Eligibility Criteria
Inclusion Criteria:
Patients deemed to be surgical candidates with focal (1-2 level) lumbar spinal stenosis (LSS) and associated stable degenerative spondylolisthesis with the following characteristics:
- a clinical history of back, buttock and leg pain with walking or standing that is improved when lying, sitting or bending forward
- a clinical history of leg symptoms that are greater than or equal to back symptoms with walking or standing, and
- greater than 6 months of symptoms with failed conservative care
- aged 50 or over
- sufficient fluency in English or French to provide informed consent and complete questionnaires with or without the need of an interpreter
Exclusion Criteria:
- Greater than 25% listhesis or spinal instability as demonstrated by motion (>5mm of translation) on flexion extension radiographs or non-loaded (MRI/CT or supine x-rays) to loaded imaging (standing radiograph)
- Presence of kyphosis (>0 degrees at the affected level or globally), degenerative scoliosis (>10 degree using the Cobb method) with rotatory or lateral listhesis on preoperative x-rays
- Clinical history of osteoporotic fracture or chronic oral steroid use
- Previous posterior lumbar spinal surgery (excluding prior microdiscectomy)
- Patients who have evidence of neurological disorders that affect physical function (e.g. peripheral neuropathy), neuromuscular disorders (e.g. multiple sclerosis, Parkinson's etc.) or systemic illness (e.g. inflammatory arthritis) that affects physical function
Sites / Locations
- Foothills Medical Centre
- Mackenzie Health Sciences Centre
- Vancouver General Hospital
- Queen Elizabeth II Health Sciences Centre
- London Health Sciences Centre - Victoria Hospital
- Sunnybrook Health Sciences Centre
- University Health Network
- Montreal General Hospital
Arms of the Study
Arm 1
Arm 2
Active Comparator
Active Comparator
Decompression with fusion
Decompression alone
Spinal decompression surgery with instrumented spinal fusion
Midline-sparing spinal decompression alone