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Dynamic Stabilization Surgery in Patients with Spinal Stenosis
- Source :
- Spine. 46:E893-E900
- Publication Year :
- 2021
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2021.
-
Abstract
- Study design Retrospective cohort study. Objective The purpose of this study was to analyze the long-term results for patients with lumbar spinal stenosis (LSS) treated with dynamic stabilization (DS) and to consider how we can improve the results. Summary of background data Few studies have reported long-term outcomes of DS surgery for LSS with or without spondylolisthesis. Methods A single-center, single-surgeon consecutive series of LSS patients who underwent DS surgery with at least five years of follow-up were retrospectively reviewed. Twenty-seven patients were included in the LSS group and 38 patients in the spondylolisthesis group. Patient characteristics, operative data, radiographic parameters, clinical outcomes, and complications were analyzed at baseline and follow-up. Results In the LSS group, all radiographic parameters (e.g., disc height, segmental lordosis, segmental range of motion [ROM] at the index level and proximal adjacent level, global lordosis, and global ROM) were maintained well until the last follow-up. In the spondylolisthesis group, global lordosis decreased from 36.5° ± 8.2° to 32.6° ± 6.0° at the last follow-up (p = 0.039), and global ROM decreased from 22.1° ± 6.9° to 18.8° ± 7.1° at the last follow-up (p = 0.012). In both groups, back pain, leg pain, and Oswestry Disability Index scores showed significant and sustained improvements. Screw loosening occurred in three patients (11.1%) in the LSS group and five patients (13.2%) in the spondylolisthesis group. Symptomatic adjacent segment degeneration (ASD) occurred in two patients (7.4%) in the LSS group and three patients (7.9%) in the spondylolisthesis group. Conclusions Decompression and DS surgery for LSS with or without spondylolisthesis showed favorable long-term surgical outcomes with an acceptable rate of complications and ASD. However, an improved physiological DS system should be developed.Level of Evidence: 4.
- Subjects :
- medicine.medical_specialty
Lumbar Vertebrae
Lordosis
business.industry
Spinal stenosis
Lumbar spinal stenosis
Retrospective cohort study
medicine.disease
Spondylolisthesis
Oswestry Disability Index
Surgery
Spinal Fusion
Spinal Stenosis
Treatment Outcome
Back pain
medicine
Humans
Orthopedics and Sports Medicine
Neurology (clinical)
Range of Motion, Articular
medicine.symptom
business
Range of motion
Retrospective Studies
Subjects
Details
- ISSN :
- 15281159 and 03622436
- Volume :
- 46
- Database :
- OpenAIRE
- Journal :
- Spine
- Accession number :
- edsair.doi.dedup.....4c167ecc841878741cad5e0bfe1cbaf5