2014, Number 2
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Acta Ortop Mex 2014; 28 (2)
Single-segment degenerative lumbar spondylolisthesis treated with an interspinous spacer
Félix-Garza R, Lagarda-Cuevas J, Chávez-Maqueda MF, Ladewig-Bernáldez GI
Language: Spanish
References: 29
Page: 88-94
PDF size: 213.31 Kb.
ABSTRACT
Background: The term degenerative spondylolisthesis, coined by Newman in 1963, refers to the forward slippage of an immediately inferior vertebra without isthmic lysis. It occurs predominantly in individuals over 40 years of age and affects mainly women, with a female:male ratio of 4:1. Prevalence is 7.5% in males and 28% in females among patients over 50 years of age with low back pain.
Material and methods: Assess the one-year results of the use of dynamic spacers for Meyerding grade 1 listhesis with the Oswestry disability scale. The patient’s electronic and radiographic records from January 2008 to December 2010 were reviewed according to different criteria to conduct a retrospective, longitudinal and observational cohort study.
Results: The preoperative Oswestry score was 3.4% mild, 55.2% moderate, and 42.4% severe; the postoperative score was 79.3% mild and 20.7% moderate. The most common surgical procedure was exploration and release in 72.4% of patients; only 27.6% underwent diskectomy. Pain irradiating to the right pelvic limb occurred in 37.9% of patients, to the left pelvic limb in 44.8%, and to both pelvic limbs in 17.2%. Only 2.4% of patients experienced postoperative pain that irradiated to the pelvic limb, as 100% of cases had some type of irradiating pain. A DIAM spacer was used in 79.3% and a Wallis device in 20.7%.
Conclusions: Treatment with an interspinous spacer results in a low reoperation rate and, at least one year later, it resulted in a significant improvement in the disability rate.
REFERENCES
Newman PH, Sonte KH: The etiology of spondylolisthesis. J Bone Joint Surg Br. 1963; 45: 39-59.
Sanderson PL, Fraser RD: The influence of pregnancy on the development of degenerative spondylolisthesis. J Bone Joint Surg Br. 1996; 78: 951-4.
Fredrickson BE, Baker D, et al: The natural history of spondylolisthesis and spondylolysis. J Bone Joint Surg Am. 1984; 66: 669-707.
Weinstein JN, Lurie JD, et al: Surgical versus nonsurgical treatment for lumbar degenerative spondylolisthesis. N Engl J Med. 2007; 356: 2257-70.
Fischgrudn JS, Macay M, et al: Degenerative lumbar spondylolisthesis with spinal stenosis: a prospective, randomized study comparing decompresive laminectomy and artrodesis with and without spinal instrumentation. Spine. 1997; 22: 2807-12.
Herkowitz HN, Kurz: Degenerative lumbar spondylolisthesis with spinal stenosis. A prospective study comparing decopression with decompression and intertransverse process artrodesis. J Bone Joint Surg Am. 1991; 73: 802-8.
Hu SS, Tribus CB, Diab M, Ghanayem AJ: Spondylolisthesis and spondylolysis. J Bone Joint Surg Am. 2008; 90: 656-71.
Zigler J, Delamarter R, et al: Results of the prospective randomized, multicenter Food and Drug Administration investigational device exemption study of the ProDisc-L total disc replacement versus circumferential fusion for the treatment of 1-level degenerative disc disease. Spine. 2007; 32: 1155-62.
Kondrashov DG, Hannibal M, et al: Interspinous process decompression with the X-STOP device for lumbar spinal stenosis: a 4-year follow-up study. J Spinal Discord Tech. 2006; 19: 323-7.
Nockels RP: Dynamic stabilization in the surgical management of painful lumbar spinal disorders. Spine. 2005; 15: S68-S72.
Mulholland RC, Sengupta DK: Rationale, principles and experimental evaluation of the concept of soft stabilization. Eur Spine J. 2002; 11: S198-S205.
McNally DS, Shackleford IM, Goodship AE, et al: In vivo stress measurement con predict pain in discography. Spine. 1996; 21: 2580; 16: 1-11.
Sengupta DK: Dynamic stabilization devices in treatment of low back pain. Orthop Clin North Am. 2004; 35: 43-56.
Lindsey DP, Swanson KE, Fuchs P, et al: The effects of an interspinous implant on the kinematics of the instrumented and adjacent levels in the lumbar spine. Spine. 2003; 28: 2192-7.
Minns RJ, Walsh WK: Preliminary design and experimental studies of a novel soft implant for correcting sagital plane instability in the lumbar spine. Spine. 1997; 22: 1819-25.
Christie SD, Song JK, Fessler RG: Dynamic interspinous process technology. Spine. 2005; 30: S72-S8
Taylor J, Pupin P, Delajoux S, et al: Device for intervertebral assisted motion: technique and initial results. Neurosurg Focus. 2007; 22(1): E6.
Bellini CM, Galbusera F, Raimondi MT, et al: Biomechanics of the lumbar spine after dynamic stabilization. J Spinal Disord Tech. 2007; 20: 423-9.
Rohlmann A, Burrea NK, Zander T, et al: Comparison of the effects of bilateral posterior dynamic and rigid fixation devices on the loads in the lumbar spine: a finite element analysis. Eur Spine J. 2007; 16: 1223-31.
Ahn YH, Chen WM, Lee KY, Park KW, Lee SJ: Comparison of the load-sharing characteristics between pedicle-based dynamic and rigid rod devices. Biomed Mater. 2008; 3(4): 044101.
Senegas J, Bernard P: Mechanical supplementation by dynamic fixation in degenerative intervertebral lumbar segments: The Wallis System. Journal of Bone & Eur Spine J. 2002; 11(Suppl 2): S164-S9.
Fairbank JC, Pynsent PB: The Oswestry Disability Index. Spine. 2000; 25(22): 2940-52.
Fairbank JCT, Couper J, Davies JB: The Oswestry low back pain questionnaire. Physiotherapy. 1980; 66: 271-3.
Meyerding HW: Spondylolisthesis. Surg Gynecol Obstet. 1932; 54: 371-7.
Meyerding HW: Spondylolisthesis. J Bone Joint Surg. 1931; 13: 39-48.
Toshinori S, Koichi S: Incidence of lumbar spondylolysis in the general population in Japan based on multidetector computed tomography scans from two thousand subjects. Spine. 2009; 34: 2346-50.
Fairbank JCT, Couper J, Davies JB, O’Brien JP: The Oswestry low back pain disability questionnaire. Physiotherapy. 1980; 66: 271-73.
Fairbank J, Pynsent PB: The Oswestry disability index. Spine. 2000; 25(22): 2940-53.
Davidson M: Rasch analysis of three versions of the Oswestry Disability Questionnaire. Manual Therapy. 2008 13: 222-31.