This article is more than 5 years old. Information may no longer be current.
Researchers report excellent clinical results for distraction laminoplasty, ILIF for lumbar stenosis
Click Here to Manage Email Alerts
Investigators found distraction laminoplasty with allograft bone block augmentation and interlaminar lumbar instrumented fusion may be a less-invasive alternative treatment for patients with lumbar stenosis.
“[The study] demonstrates excellent clinical outcomes and an acceptable rate of radiographic fusion success,” the authors wrote.
Researchers collected data from two sites for the prospective clinical study of 37 patients with single-level degenerative disc disease between L1-2 and L4-5 with neurogenic claudication. Patients underwent lumbar decompression with distraction laminoplasty and interlaminar lumbar instrumented fusion.
Investigators performed follow-up clinical evaluations at 3 months, 6 months, 12 months and 24 months. Evaluation included VAS pain score, Oswestry Disability Index (ODI), Zurich Claudication Questionnaire scores, and return to activity and work. During the 2-year follow-up, investigators also performed radiographic evaluations for fusion and segmental and regional lumbar lordosis.
All 2-year follow-up criteria were met by 33 of the original 37 patients. Most patients were treated at the L4-5 level. Grade 1 spondylolisthesis was seen in 32 of the 37 patients. The mean length of hospital stay was 2 days. Complications included a dural tear, new neurological deficit, implant failure, seroma and cancer diagnosis (all one each).
A minimal clinically important difference (MCID) of 2 cm or greater improvement on the VAS was seen in 67% of patients at 2 years, and 73% of patients showed an MCID of about 12% or greater improvement on the ODI. The Zurich Claudication symptom severity and physical function subscores improved in 76% and 73% of patients, respectively, by more than 0.5 cm. At 2-years postoperatively, 94% of patients stopped taking opiate analgesic medications and the same percentage of patients were satisfied with the surgery. At both baseline and 2 years, the mean lumbar lordosis was about 53°. Overall, 72% of patients met the criterion for fusion (<3° of flexion/extension on X-ray and bridging bone) and 97% of patients met stability criteria. ‒ by Monica Jaramillo
Disclosure: The study was supported by NuVasive Inc.
Click Here to Manage Email Alerts