SRS Morbidity And Mortality Committee Analysis of Changing Surgical Treatment Trends for Spondylolisthesis 1996 TO 2002

Purpose: To analyze morbidity and mortality data related to changing treatment trends for degenerative and isthmic spondylolisthesis.

Materials and Methods: SRS members submitted M and M data for 96,913 spine operations from 1996 to 2002 using computerized data questions developed in 1992. Members reported 6425 operations for degenerative spondylolisthesis and 3619 operations for isthmic spondylolisthesis. Changing treatment trends were correlated with M and M data for statistical relevance.

Results: Since 1996 the following characteristics for spondylolisthesis operations have remained constant: percentage of spine patients operated for spondylolisthesis (9.1 - 11.1%), percent fused (92-95%), percent fused using implants (75-82%). There has been a gradual trend to reduce slips in more patients. Since 1997, reduction of degenerative slips gradually increased from 14.9% to 33% of patients. Isthmic spondylolisthesis reductions with fusion increased from 22% to 44 %. Neurologic deficit rates have remained steady for degenerative slips (range 0.3 to 1.0%), but have steadily increased for isthmic slips (1.3 to 3.1%) during the same time period. Other morbidities have remained constant, i.e. deaths, infections, dural tears, pulmonary and implant complications. Further data analysis was constrained by the data questionnaire.

Conclusion: An increased neurologic deficit rate has accompanied a trend to reduce more slips since 1996. Newly revised M and M data questions instituted for 2003 will allow better stratification of data to identify causative relationships.