TY - JOUR
T1 - Long-term outcomes after non-instrumented lumbar arthrodesis
AU - Santiago-Dieppa, David
AU - Bydon, Mohamad
AU - Xu, Risheng
AU - De La Garza-Ramos, Rafael
AU - Henry, Roger
AU - Sciubba, Daniel M.
AU - Wolinsky, Jean Paul
AU - Bydon, Ali
AU - Gokaslan, Ziya L.
AU - Witham, Timothy F.
PY - 2014/8
Y1 - 2014/8
N2 - Non-instrumented lumbar fusion is an accepted technique for the treatment of various spinal degenerative pathologies. The purpose of this study is to report long-term outcomes of patients undergoing in situ fusion. A retrospective review was performed at a single institution over a 20 year period. The main outcome variables were symptom resolution at last follow-up, development of adjacent segment disease (ASD) and overall need for re-operation. A total of 376 patients were identified, with a mean age of 61.1 ± standard deviation of 13.54 years. The most common presenting symptom was back pain in 344 (91.5%) patients, followed by radiculopathy in 304 (80.9%) patients. The most common pre-operative diagnosis was multi-level spinal stenosis with claudication in 211 (56.1%) patients. At last follow-up, the prevalence of back pain (60.64%; p < 0.001) and radiculopathy (57.71%; p < 0.001) were significantly lower. The cumulative rate of ASD was 18.35% (69 patients). In total, the rate of re-operation due to non-improvement or worsening of symptoms was 30.59% (115 patients). In this manuscript, we present one of the largest cohorts of patients undergoing in situ fusion for degenerative lumbar spine disease with a median follow-up time of 92 (range 24-154) months. Although the prevalence of both back pain and radiculopathy was significantly reduced at last follow-up, a significant portion of patients still experienced continued symptoms. Notably, while 18.35% of patients developed ASD, 30.6% of patients required re-operation due to recurrent or worsening symptoms during the follow-up period, highlighting the need for additional stabilization techniques.
AB - Non-instrumented lumbar fusion is an accepted technique for the treatment of various spinal degenerative pathologies. The purpose of this study is to report long-term outcomes of patients undergoing in situ fusion. A retrospective review was performed at a single institution over a 20 year period. The main outcome variables were symptom resolution at last follow-up, development of adjacent segment disease (ASD) and overall need for re-operation. A total of 376 patients were identified, with a mean age of 61.1 ± standard deviation of 13.54 years. The most common presenting symptom was back pain in 344 (91.5%) patients, followed by radiculopathy in 304 (80.9%) patients. The most common pre-operative diagnosis was multi-level spinal stenosis with claudication in 211 (56.1%) patients. At last follow-up, the prevalence of back pain (60.64%; p < 0.001) and radiculopathy (57.71%; p < 0.001) were significantly lower. The cumulative rate of ASD was 18.35% (69 patients). In total, the rate of re-operation due to non-improvement or worsening of symptoms was 30.59% (115 patients). In this manuscript, we present one of the largest cohorts of patients undergoing in situ fusion for degenerative lumbar spine disease with a median follow-up time of 92 (range 24-154) months. Although the prevalence of both back pain and radiculopathy was significantly reduced at last follow-up, a significant portion of patients still experienced continued symptoms. Notably, while 18.35% of patients developed ASD, 30.6% of patients required re-operation due to recurrent or worsening symptoms during the follow-up period, highlighting the need for additional stabilization techniques.
KW - Fusion
KW - In situ
KW - Lumbar
KW - Outcomes
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UR - http://www.scopus.com/inward/citedby.url?scp=84904250497&partnerID=8YFLogxK
U2 - 10.1016/j.jocn.2014.02.010
DO - 10.1016/j.jocn.2014.02.010
M3 - Article
C2 - 24831342
AN - SCOPUS:84904250497
VL - 21
SP - 1393
EP - 1397
JO - Journal of Clinical Neuroscience
JF - Journal of Clinical Neuroscience
SN - 0967-5868
IS - 8
ER -