NDLI: Anterior and Lateral Lumbar Interbody Fusion With Supplemental Interspinous Process Fixation: Outcomes from a Multicenter, Prospective, Randomized, Controlled Study.

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Anterior and Lateral Lumbar Interbody Fusion With Supplemental Interspinous Process Fixation: Outcomes from a Multicenter, Prospective, Randomized, Controlled Study.

Content Provider	Europe PMC
Author	PANCHAL, RIPUL DENHAESE, RYAN HILL, CLINT STRENGE, K. BRANDON DE MOURA, ALEXANDRE PASSIAS, PETER ARNOLD, PAUL CAPPUCCINO, ANDREW DENNIS, M. DAVID KRANENBURG, ANDY VENTIMIGLIA, BRIETA MARTIN, KIM FERRY, CHRIS MARTINECK, SARAH MOORE, CAMILLE KIM, KEE
Copyright Year	2018
Abstract	Background Rigid interspinous process fixation (ISPF) has received consideration as an efficient, minimally disruptive technique in supporting lumbar interbody fusion. However, despite advantageous intraoperative utility, limited evidence exists characterizing midterm to long-term clinical outcomes with ISPF. The objective of this multicenter study was to prospectively assess patients receiving single-level anterior (ALIF) or lateral (LLIF) lumbar interbody fusion with adjunctive ISPF. Methods This was a prospective, randomized, multicenter (11 investigators), noninferiority trial. All patients received single-level ALIF or LLIF with supplemental ISPF (n = 66) or pedicle screw fixation (PSF; n = 37) for degenerative disc disease and/or spondylolisthesis (grade ≤2). The randomization patient ratio was 2:1, ISPF/PSF. Perioperative and follow-up outcomes were collected (6 weeks, 3 months, 6 months, and 12 months). Results For ISPF patients, mean posterior intraoperative outcomes were: blood loss, 70.9 mL; operating time, 52.2 minutes; incision length, 5.5 cm; and fluoroscopic imaging time, 10.4 seconds. Statistically significant improvement in patient Oswestry Disability Index scores were achieved by just 6 weeks after operation (P < .01) and improved out to 12 months for the ISPF cohort. Patient-reported 36-Item Short Form Health Survey and Zurich Claudication Questionnaire scores were also significantly improved from baseline to 12 months in the ISPF cohort (P < .01). A total of 92.7% of ISPF patients exhibited interspinous fusion at 12 months. One ISPF patient (1.5%) required a secondary surgical intervention of possible relation to the posterior instrumentation/procedure. Conclusion ISPF can be achieved quickly, with minimal tissue disruption and complication. In supplementing ALIF and LLIF, ISPF supported significant improvement in early postoperative (≤12 months) patient-reported outcomes, while facilitating robust posterior fusion.
Related Links	https://europepmc.org/backend/ptpmcrender.fcgi?accid=PMC6159706&blobtype=pdf
Volume Number	12
DOI	10.14444/5025
PubMed Central reference number	PMC6159706
Issue Number	2
PubMed reference number	30276077
Journal	International Journal of Spine Surgery [Int J Spine Surg]
e-ISSN	22114599
Language	English
Publisher	International Society for the Advancement of Spine Surgery
Publisher Date	2018-04-01
Access Restriction	Open
Rights License	©International Society for the Advancement of Spine Surgery 2018
Subject Keyword	interspinous process fixation ISPF lateral lumbar interbody fusion LLIF anterior lumbar interbody fusion ALIF degenerative disc disease lumbar spine posterior fixation minimally invasive MIS spondylolisthesis
Content Type	Text
Resource Type	Article
Subject	Orthopedics and Sports Medicine Surgery

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