Lumbar Decompression and Interbody Fusion Improves Gait Performance, Pain, and Psychosocial Factors of Patients With Degenerative Lumbar Spondylolisthesis

Abstract

Study Design: Prospective cohort study. Objective: Evaluate changes in gait, pain, and psychosocial factors among degenerative lumbar spondylolisthesis (DLS) patients before and 3 months after surgical intervention. Methods: Forty-four symptomatic DLS patients performed clinical gait analysis 1 week before surgery and 3 months after surgery. Patients performed a series of over-ground gait trials at a self-selected speed. Twenty-two matched asymptomatic controls underwent the same battery of tests. Three-dimensional motion tracking was used to analyze gait kinematics. Patient-reported outcomes, gait range of motion, and spatiotemporal parameters compared before and after lumbar decompression with fusion. Results: Surgical intervention resulted in significant improvements in walking speed (P =.021), stride time (P =.020), step time (P =.014), and single-support time (P =.038). Significant improvements in joint range-of-motion were found for knee (P =.002) and hip flexion (P =.006). Degenerative lumbar spondylolisthesis patients reported significant reductions in pain, disability, and improved psychological perceptions for fear-avoidance of pain and motion (all P