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Background and Aim: In patients with spondylolisthesis, both conservative and surgical approaches are considered based on the stage of the disease. However, in addition to the technical characteristics of the surgery and the stage of the disease, the underlying characteristics of the patients may also affect the therapeutic prognosis. In this regard, some studies have indicated that the surgical prognosis is worse in diabetic and hypertensive patients and also preoperative medical treatments, such as anticoagulants may be effective in the prognosis of the disease. The aim of this study was to evaluate the role of underlying risk factors, such as diabetes mellitus, hypertension, and anticoagulant conditions (such as aspirin) in worsening outcomes after surgery in patients with spondylolisthesis. Methods and Materials/Patients: This cross-sectional study was conducted on 130 patients suffering from spondylolisthesis and scheduled for surgery. According to baseline characteristics, 65 patients with a history of diabetes mellitus, hypertension, and receiving aspirin were categorized as the case group, and 65 sex- and age matched individuals without such comorbidities as the control group. Preoperative and postoperative radicular pain intensity, wound healing, and discharge from the surgical site were considered the study outcomes. Results: The two groups with and without comorbidities were matched for gender, mean age, mean body mass index, and time of operation. Preoperative pain intensity was similar in the groups, but those with comorbidities experienced higher radicular pain severity postoperatively. We showed no difference in the rate of surgical site discharging, but the lack of wound healing was significantly higher in those with comorbidities. Conclusion: In patients with spondylolisthesis and candidates for surgical treatment, a history of diabetes mellitus, hypertension, and aspirin can be associated with a worse prognosis, including no improvement in pain and lack of wound healing.

Background and Aim: The present study was conducted to investigate the effects of granulocyte colony-stimulating factor (G-CSF) after acute spinal cord injury on increasing a grade of improvement entitled American spinal cord injury association impairment scale (AIS) as an individual participant data (IPD) meta-regression analysis of clinical trials. Methods and Materials/Patients: According to our search strategy, four studies were selected. Multilevel ordered logistic regression modeling was used to predict AIS grade with G-CSF administration and time variable (first day and a 3-month follow-up). The IDs of the studies as well as the time series variable were imported to the random part of the model. Odds ratio (OR) and 95% confidence interval (CI) were reported. Results: A total of 277 samples were studied. A fixed effect model was performed at first. Accordingly, using G-CSF was associated with increased AIS grade (lower impairment) (OR=1.503, 95% CI=1.110-2.035) adjusted with time series (OR=1.868, 95% CI=1.378-2.532). In the mixed effect model, G-CSF was again associated with increased AIS grade (OR=1.780, 95% CI=1.301- 2.436) adjusted with time series (OR=2.152, 95% CI=1.406-3.294). Conclusion: The present meta-analysis showed the protective effect of GCS-F observed as an improvement in AIS grade. This protecting effect was further after adjusting the random effects of time series and individual studies. Although multilevel modeling could reduce our limitations, it should be regarded that the number of trials was not enough to establish strong conclusions.

Background and Importance: Dural ectasia is circumferential extension or dilatation of the dural sac, it is commonly associated with Neurofibromatosis type 1 (NF1). Because NF1 is associated with a high likelihood of tumor formation, it is critical to distinguish it from other posterior mediastinal cancers such as neurofibroma, neuroblastoma, and ganglioneuroma. Scoliosis is the most frequently observed feature in NF1 patients with spinal deformities. Moreover, there are several distinctive radiographic features, including dural ectasia, defective pedicles, and spondylolisthesis, which are relatively less common in these patients. Surgery may be performed for stabilization of the spine. Case Presentation: The present study reports on a 62-year-old female with neurofibromatosis type 1 who was referred for an unusual chest X-ray and chest Computed Tomography (CT) revealing a thoracic mass while she was hospitalized and under observation for dyspnea. The chest X-ray film showed homogenous opacity with a well-defined margin in the right apex. The chest CT showed an enlarged intervertebral foramen and defected vertebral arch around the mass and scoliosis. Although the pre-operative diagnosis was dumbbell type neurinoma, the tumor was found to be a protrusion of dura mater with spinal fluid out of the spinal canal. Part of the wall was excised, the residual opening was repaired, and surgical stabilization was performed. Conclusion: Retrospectively, magnetic resonance imaging showed the characteristics of thoracic dural ectasia and anterior meningocele, which, in an asymptomatic case, require regular radiographic follow-ups. Surgical intervention is an alternative for patients with spinal deformities or symptomatic patients due to the adverse effects of spinal cord compression and mediastinal structures.

Background and Aim: It is still unclear whether the surgical or conservative approach has the best recovery and the least adverse outcomes after the treatment of patients with traumatic brain injury (TBI), especially the elderly. The use of invasive versus conservative therapies in elderly patients with TBI is controversial, and the current brain surgery procedures for the elderly require further evaluation. Methods and Materials/Patients: In this retrospective cohort study, the medical records of 238 patients with TBI (119 surgical patients and 119 patients treated with conservative methods) over the age of 65 were reviewed. The patients were compared for the degree of recovery indicated by the Glasgow outcome score (GOS) and postoperative complications. Results: No difference was found in the primary Glasgow coma scale (GCS) between surgical and conservative approaches, but after two treatment protocols, the assessment of GCS and GOS showed a significant difference between the two groups; however, after adjusting baseline parameters in a multivariable logistic regression model, the difference between the two groups in CGS and recovery state turned to insignificance. There was no difference between surgical and conservative management in the post-treatment sequels, including contusion, hydrocephalus, myocardial infarction, pulmonary infection, and death. However, the recurrence of hematoma was significantly higher in those who were treated by the conservative method even after multivariate regression modeling. Conclusion: In TBI patients aged over 65 years, surgical management can result in more favorable outcomes compared with the conservative approach.

Background & Importance: Spondylodiscitis is an inflammatory disease of the body of one or more vertebrae and intervertebral disc. The fungal etiology of this disease is rare particularly in patients whit out immune dysfunction. Delay in diagnosis and treatment of this disease can lead to complications and even death. Case Presentation: A 63-year-old female patient, who had a history of spinal surgery and complaining of radicular lumber pain in both lower limbs with probable diagnosis of Spondylodisties, underwent L1 and complete L3 and L4 partial correctomy. As a result of pathology from tissue biopsy specimen, Aspergillus fungi was observed. Conclusion: There was no evidence of immunosuppresive status in the patient. The patient was treated with Itraconazol 100mg twice a day for two months. Pain, neurological and laboratory symptoms improved.

Background and Aim: Conus medullaris dermoid cysts are benign lesions, usually observed in the lumbosacral region of the spinal canal. Such lesions are often associated with congenital dermal sinus tracts and spinal dysraphism. Case Presentation: We reported a 37-year-old man with progressive paralysis distal part of the left lower limb presented to our clinic. The MRI of the lumbar spine, as a modality of choice, has revealed a well-defined sausage-shaped lesion, a multilobular cyst, and the heterogeneous contrast enhancement of an intra- and extra-medullary lesion in the conus medullaris region. Conclusion: Subtotal microsurgical resection was performed on the lesion. The result of histopathological examination confirmed the dermoid cyst, as well. After conducting the subtotal resection, an appropriate clinical result was achieved in the patient.

Background and Aim: This study aimed to present the results of early and delayed operation on patients with ruptured brain aneurysms. In addition to comparing the results and rates of morbidity and mortality in the surgical procedure and identifying the effective factors, this study aimed to provide methods to improve the treatment of brain aneurysm. Methods and Materials/Patients: This was a retrospective study on 60 patients with a definitive diagnosis of brain aneurysm admitted to Neurosurgery Ward of Poursina Hospital, Rasht, Iran from 2009 to 2013. Results: 7(11.7%) patients on the first 3 days and 37(61.7%) patients on the days 4-14 and 16(26.7%) after 2 weeks and selectively underwent surgery. In total, 11.7% of patients died and 15% developed severe complications. In the group underwent surgery on the first 3 days, 2(28.5%) patients died and 2 experienced severe complications. In the second group (in 4-14 days), 4(10.8%) patients died and 5(13.5%) suffered from severe complications, and in the group (16 patients) with delayed surgeries, 1(6.2%) patient died and 2(12.5%) suffered from severe complications. Neurological grading and operation time were important factors in complications and mortality of patients. Conclusion: This study showed that Hunt and Hess neurological grading score has a direct relationship with increased morbidity and mortality rates, while delayed operation is associated with a reduction in morbidity and mortality. Given the complications of early aneurysm surgery (during the first 3 days) compared with delayed surgery, and also most of these patients die due to vasospasm or recurrent hemorrhage before the onset of a delayed phase, performing early surgery in these patients requires further evaluation. According to this study, the reduction of each episode of occlusion with temporary clipping will result in fewer complications.

Background and Importance: A 60-year-old diabetic man with simultaneous diffuse idiopathic hyperostosis, massive ossification of the posterior longitudinal ligament and cervical and higher part of thoracic ligamentum flavum is reported in this article. Such comorbidity rarely occurs. Case Presentation: The patient’s chief complaint was sensation abnormalities without gait disturbance or severe cord compression symptoms despite the advanced stage of the disease. Computed tomography scan and magnetic resonance imaging confirmed multi-level involvement of cervicothoracic spine. Conclusion: After surgical treatment, his symptoms resolved completely with no complication.

Background & Aim: Spinal cord injury (SCI) is one of the worst kinds of traumatic injuries with remarkable social and economic effects on communities. Methods & Materials/Patients: In this prospective randomized clinical trial, 122 patients with traumatic spinal cord injury were admitted to Poursina hospital within 48 hours of injury to compare granulocyte colony stimulating factor (G-CSF) and high-dose methylprednisolone as neuroprotective therapy. Results: In this research, 122 patients were studied out of whom 62 patients were included in the granulociote colony-stimulating factor (G-CSF) group with a mean age of 40.4, and 60 patients in the methylprednisolone group with an average age of 40.10 years. 55 out of 122 patients (45%) were completely paralyzed (Grade AIS:A) and 67 (55%) were with incomplete spinal injury (Grade AIS:B,C,D). The average American spinal injury association (ASIA) sensory scores in the two groups were similarly compared in the same four time intervals, and p values were 0.7, 0.3, 0.2, and 0.1. They were not statistically significant. Conclusion: According to the results, the G-CSF was shown to be beneficial in average ASIA motor and sensory scores in the two groups of male patients at six months of onset of G-CSF treatment (p value=0.04), and average ASIA motor scores improvement in the falls subgroup patients also differed significantly within six months of onset of G-CSF treatment (p value=0.03). A multicentre prospective randomized clinical trial to compare the placebo effect with G-CSF protocol's treatment, and also assessment of the cost benefits of the common medical treatment versus G-CSF are needed.

Background & Importance: Hydatid disease of the spine is rare but constitutes approximately 50% of bone involvement cases in human hydatidosis. It is a severe condition associated with a high rate of morbidity, disability and mortality. Case Presentation: In the present paper, we report an intriguing case of cervical spinal hydatid disease mimicking traumatic burst fracture. Conclusion: A high degree of suspicion combined with good-quality neuroimaging is important for early and correct diagnosis. Because of the

Background & Aim: DBS (deep brain stimulation) is a new and successful technique in treatment of symptoms of Parkinsonism especially after drug resistance. Research in this field is mostly designed for evolution of this technique. The present study aimed at evaluating the relationship between the angle formed in midsagittal and STN (sub-thalamic nucleus) axis line and recording length in the final electrode p lacement. Methods & Materials/Patients: 46 patient candidates for DBS operation were studied in terms of demographic variables, STN nucleus length, the angle between midsagittal line and STN axis (p angle), the number of tested electrodes, force and length of final electrode registration and final coordinates of the placed electrode. The primary information was obtained from patients records and other technical information based on MRI imaging using Stereonata software and during surgery. The information were analyzed using SPSS (version 16) and descriptive analysis and linear relationship. Results: The mean force of the recording from trial microelectrodes implanted in the right side ranged from 1.49 ± 1.45 to 2.65 ± 1.42 and in the left side from 1.53 ± 1.35 to 2.65 ± 2.30. In comparative analysis, no significant statistical relationship was found between P angle of the right side and degree registered in the final electrode of the right side (Pearson correlation: 0.314, P value= 0.049). Conclusion: Not only accurate electrodes positioning in the STN can lead to improved outcome within bilateral STN DBS, but also optimizing defined P angle can have beneficial effects on intraoperative outcome after STN DBS.

Background and Aim: Traumatic subdural hygroma is the accumulation of CSF (cerebrospinal fluid) in subdural space following head trauma. The mass effect of hygroma on brain can impinge on consciousness. There are still many ambiguities on indications of hygroma surgery. This is an 11-year follow-up study which involves the patients suffering traumatic subdural hygroma who underwent surgery. Methods & Materials/Patients: In this retrospective study, clinical records of 16 patients who were operated due to traumatic subdural hygroma were studied. The data from existing records in the hospital were collected and analyzed. They were then analyzed by Repeated Measures ANOVA using SPSS (Version 18). The differences were considered statistically significant at P≤0.05. Results: In this study, there were 13 men (81.3%) and 3 women (18.7%) (Mean age=62 years old). In 87.75% of patients, hygroma was diagnosed 6 days after head injury. It wasunilateral in majority of patients (56.3%) and located in fronto-parietal area (81.3%). The most frequent concomitant injuries were contusions (25%) and subarachnoid hemorrhage (18.8%), respectively. GCS trend on admission and at discharge was significantly different fromthat of hygroma formation (P

Background & Aim: Glioblastoma multiforme (GBM), the highest grade glioma (grade IV), is the most malignant form of astrocytoma in adults. This study aimed at evaluating the relationship between demographic, clinical and medical factors with GBM outcome. Methods & Materials/Patients: Through a cross-sectional design, 58 patients with newly diagnosed GBM were studied from 1999 to 2015 in Guilan province (North of Iran). Demographic, clinical and medical data including age, gender, score of Karnofsky Performance Scale (KPS), status at discharge, extent of resection (EOR) and administration of post-operative radio-chemotherapy were recorded in an individual questionnaire. The data were analyzed using chi-square and fisher exact tests. Results: Of all patients, 35 (60.3%) cases were men and 23 (39.7%) were women. Age range (at the time of diagnosis of GBM) was 18-82 years (54.86±16.34). The most common side and location of tumor were left hemisphere and frontal lobe, respectively. 41 patients (70.7%) received total surgical resection. Half of patients were treated with simultaneous post-operative radiation therapy and chemotherapy.11 (19%) of all cases died. About 41 (70.6%) of patients demonstrated KPS 50-70. Conclusion: GBM is a frequent malignant brain tumor with male predominance and high occurrence in age range of ≥50 years. The number of dead patients increases with decreased KPS. Total surgical resection followed by concomitant radiation therapy and chemotherapy were common standard therapeutic regimens.

Background & Aim: Spondylolisthesis is a visible deformity in lumbosacral region with vertebral slip and fracture or other deformities of pars interarticularis. This study aims at investigating the characteristics of spondylolisthesis surgery in operated patients. Methods & Materials/Patients: This is a retrospective study which included all the patients who had undergone spondylolisthesis surgery by one same surgeon from 2006 to 2011. Demographic characteristics such as age, gender, and surgery information including type of spondylolisthesis, incision site, laminectomy site, foraminotomy site, fixation site of vertebra and site of vertebral disc evacuation were collected. The data were analyzed using SPSS (Version16). Results: 52 of 63 enrolled patients were women (82.5%) and 11 men (17.5%) with mean age of 49.6 years. Based on frequency, spondylolisthesis types were 60 degenerative (95.2%), 2 post-surgical (3.2%) and 1 post-traumatic (1.6%), respectively. 58 patients had spondylolisthesis only in one vertebra and 5 patients in two vertebrae. The total number of slipped vertebrae was 68, in which slip was seen in L3, L4 or L5 vertebrae. In 42 patients, laminectomy was performed only in one vertebra, in 19 patients in two vertebrae, in 1 patient in three vertebrae and in 1 patient in five vertebrae. The total number of vertebrae with foraminotomy was 106. The highest frequency of foraminotomy was seen in L5, L4, and S1 vertebrae, respectively. Except in one case, the rest 62 patients underwent fixation surgery in two or three vertebrae. Conclusion: Based on the results, the frequency of spondylolisthesis was approximately five times in women compared to men. The most common type was degenerative spondylolisthesis. Type of surgery was fixation with pedicle screw and fusion.

Background & Aim: The purpose of this study was to evaluate and compare the pain of patients with spondylolisthesis who had undergone either of the surgery techniques: posterolateral fusion (PLF) or posterior lumbar interbody fusion (PLIF). Methods & Materials/Patients: In a prospective observational study, 102 surgical candidates with low grade degenerative and isthmic spondylolisthesis were enrolled from 2012 to 2014. The observed patients were into two groups: PLF and PLIF. Assessing of pain has been done by a questionnaire using Visual Analogue Scale (VAS) scores. The questionnaire was completed by all patients before surgery, the day after surgery, after six months and after one year. Results: There were no statistically significant differences in terms of age and sex distribution, type of spondylolisthesis and pre-operation pain between groups (p>0.05). Comparison of the mean VAS scores of two groups over the whole study period showed a significant statistical difference (p-value0.05), but the difference of mean VAS scores between groups 6 months after surgery was statistically significant (p

Background & Aim: Patients with spinal cord injury (SCI) impose a heavy burden on health care system. Awareness on prevalence and incidence of SCI is important because this would show the necessity of prevention. This study aimed to investigate the epidemiology and types of traumatic spinal cord injuries in a trauma referral center in Guilan. Methods & Materials/Patients: This is a descriptive study which was conducted on patients with spinal cord trauma using a questionnaire during one year. The questionnaire included demographic information, injured spinal cord area, mechanism of injury, and type of neural damage based on ASIA scale. The data were analyzed using SPSS18 and descriptive statistics. Results: Out of 76 study patients, 68 (88.2%) were men with mean age of 35.2 ± 1.45 years. The most common cause of SCI was motor vehicle accidents (MVA) (48.7%). 34 patients (44.7%) had cervical spine injury and in 23 patients (30.3%), thoraco-lumbar injuries caused SCI. 29.7% of patients suffered from paraplegia and 10.8% quadriplegia. 25 patients (38.5%) had complete SCI. 7 patients with SCI (9.2%) died during hospitalization. In this study, increased age was identified as a risk factor for death. In 4 of these patients (57.1%) cervical SCI was the underlying cause of death. Conclusion: Young men were the group at highest risk and the most mechanism leading to SCI was motor vehicle accidents. Many of these accidents are preventable; thus, more attention should be devoted to safety policies based on needs of the vulnerable groups. Besides, comprehensive education program with clear and practical goals should be developed.

Background & Aim: Although most patients experience severe pain after major spinal fixation surgery, little attention has been paid to control it with a multi-modal approach. The aim of this study is to select appropriate method of pain management after spinal surgery. Methods & Materials/Patients: This study was a randomized clinically controlled trial in candidates of spondylolisthesis and spinal fixation surgery under general anesthesia. 90 patients were divided into three groups, as follows: 1) Intervention group of epidural fentanyl (F): patient-controlled analgesia (PCA) pump infused 100 µg of fentanyl and 98cc of normal saline at the rate of 3-5 ml/h in the epidural space via an epidural catheter placed by surgeon 2) Intervention group of epidural fentanyl-bupivacaine (FB): PCA pump infused 100 µg of fentanyl and bupivacaine 0.125% at the rate of 3-5 ml/h in the epidural space. 3) IV morphine group (M): No medication was received epidurally. In case of visual analog scale (VAS) score more than four, one mg of IV morphine bolus was administered to patient. The blood pressure, heart rate, respiratory rate and pain severity were recorded at the moment of patient’s transfer from recovery room to the ward and compared in three groups every six hours for 24 hours. The results of this study were analyzed by statistical tests including repeated measures ANOVA, Kruskal-Wallis, Fisher’s exact test and SPSS software 16. P values less than 0.05 were considered statistically significant. Results: The results of the study showed that VAS score in fentanyl-bupivacaine group was significantly lower than that in the two other groups during the first 18 hours. However, VAS score in all groups decreased at 24th hour postoperatively (less than three) suggesting that there was no statistically significant difference between the three groups. In this study, no serious and severe complications were observed except for a few cases of nausea in the control group. Conclusion: Epidural analgesia with fentanyl-bupivacaine is a safe and effective way to postoperative pain management in listhesis and spinal surgeries.

Introduction: Thermal ablation by microwave (MWA) has proven efficacy in treatment of primary and metastatic cancers. Soft tissue tumors could be ablated completely using MWA. However, bony tissue metastasis particularly spinal vertebral metastasis ablation has not reported yet. Case presentation: A 50 year old male patient with primary diagnosed colon cancer undergone surgical resection of tumor. Recently, he was diagnosed with metastasis to liver and spinal vertebral bone. He was referred to pain clinic with severe non-radiating back pain. In MRI Imaging, hyperdensity lesions were identified on body of L5 and T12 and in spinal canal of L1 indicating metastatic involvement. Under fluoroscopy guidance, the metastatic tumor was ablated by MWA and the generator was powered to 20 Watt/3 minutes in the temperature control mode. Patient had no low back pain afterward. Conclusion: MWA could be used to ablate vertebral bone metastasis without any complications and with good prognosis

Background and Aim: It is still unclear whether the surgical or conservative approach has the best recovery and the least adverse outcomes after the treatment of patients with traumatic brain injury (TBI), especially the elderly. The use of invasive versus conservative therapies in elderly patients with TBI is controversial, and the current brain surgery procedures for the elderly require further evaluation. Methods and Materials/Patients: In this retrospective cohort study, the medical records of 238 patients with TBI (119 surgical patients and 119 patients treated with conservative methods) over the age of 65 were reviewed. The patients were compared for the degree of recovery indicated by the Glasgow outcome score (GOS) and postoperative complications. Results: No difference was found in the primary Glasgow coma scale (GCS) between surgical and conservative approaches, but after two treatment protocols, the assessment of GCS and GOS showed a significant difference between the two groups; however, after adjusting baseline parameters in a multivariable logistic regression model, the difference between the two groups in CGS and recovery state turned to insignificance. There was no difference between surgical and conservative management in the post-treatment sequels, including contusion, hydrocephalus, myocardial infarction, pulmonary infection, and death. However, the recurrence of hematoma was significantly higher in those who were treated by the conservative method even after multivariate regression modeling. Conclusion: In TBI patients aged over 65 years, surgical management can result in more favorable outcomes compared with the conservative approach. [ABSTRACT FROM AUTHOR]

Background and Aim: The present study was conducted to investigate the effects of granulocyte colony-stimulating factor (G-CSF) after acute spinal cord injury on increasing a grade of improvement entitled American spinal cord injury association impairment scale (AIS) as an individual participant data (IPD) meta-regression analysis of clinical trials. Methods and Materials/Patients: According to our search strategy, four studies were selected. Multilevel ordered logistic regression modeling was used to predict AIS grade with G-CSF administration and time variable (first day and a 3-month follow-up). The IDs of the studies as well as the time series variable were imported to the random part of the model. Odds ratio (OR) and 95% confidence interval (CI) were reported. Results: A total of 277 samples were studied. A fixed effect model was performed at first. Accordingly, using G-CSF was associated with increased AIS grade (lower impairment) (OR=1.503, 95% CI=1.110-2.035) adjusted with time series (OR=1.868, 95% CI=1.378-2.532). In the mixed effect model, G-CSF was again associated with increased AIS grade (OR=1.780, 95% CI=1.301- 2.436) adjusted with time series (OR=2.152, 95% CI=1.406-3.294). Conclusion: The present meta-analysis showed the protective effect of GCS-F observed as an improvement in AIS grade. This protecting effect was further after adjusting the random effects of time series and individual studies. Although multilevel modeling could reduce our limitations, it should be regarded that the number of trials was not enough to establish strong conclusions. [ABSTRACT FROM AUTHOR]

Background and Aim: In patients with spondylolisthesis, both conservative and surgical approaches are considered based on the stage of the disease. However, in addition to the technical characteristics of the surgery and the stage of the disease, the underlying characteristics of the patients may also affect the therapeutic prognosis. In this regard, some studies have indicated that the surgical prognosis is worse in diabetic and hypertensive patients and also preoperative medical treatments, such as anticoagulants may be effective in the prognosis of the disease. The aim of this study was to evaluate the role of underlying risk factors, such as diabetes mellitus, hypertension, and anticoagulant conditions (such as aspirin) in worsening outcomes after surgery in patients with spondylolisthesis. Methods and Materials/Patients: This cross-sectional study was conducted on 130 patients suffering from spondylolisthesis and scheduled for surgery. According to baseline characteristics, 65 patients with a history of diabetes mellitus, hypertension, and receiving aspirin were categorized as the case group, and 65 sex- and age-matched individuals without such comorbidities as the control group. Preoperative and postoperative radicular pain intensity, wound healing, and discharge from the surgical site were considered the study outcomes. Results: The two groups with and without comorbidities were matched for gender, mean age, mean body mass index, and time of operation. Preoperative pain intensity was similar in the groups, but those with comorbidities experienced higher radicular pain severity postoperatively. We showed no difference in the rate of surgical site discharging, but the lack of wound healing was significantly higher in those with comorbidities. Conclusion: In patients with spondylolisthesis and candidates for surgical treatment, a history of diabetes mellitus, hypertension, and aspirin can be associated with a worse prognosis, including no improvement in pain and lack of wound healing. [ABSTRACT FROM AUTHOR]