Superior outcomes of decompression with an interlaminar dynamic device versus decompression alone in patients with lumbar spinal stenosis and back pain: a cross registry study.

Röder, C; Baumgärtner, B; Berlemann, U; Aghayev, E (2015). Superior outcomes of decompression with an interlaminar dynamic device versus decompression alone in patients with lumbar spinal stenosis and back pain: a cross registry study. European spine journal, 24(10), pp. 2228-2235. Springer 10.1007/s00586-015-4124-6

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INTRODUCTION Surgical decompression for lumbar spinal stenosis (LSS) has been associated with poorer outcomes in patients with pronounced low back pain (LBP) as compared to patients with predominant leg pain. This cross registry study assessed potential benefits of the interlaminar coflex® device as an add-on to bony decompression alone. METHODS Patients with lumbar decompression plus coflex® (SWISSspine registry) were compared with decompressed controls (Spine Tango registry). Inclusion criteria were LSS and a preoperative back pain level of ≥5 points. 1:1 propensity score-based matching was performed. Outcome measures were back and leg pain relief, COMI score improvement, patient satisfaction, complication, and revision rates. RESULTS 50 matched pairs without residual significant differences but age were created. At the 7-9 months follow-up interval the coflex® group had higher back (p=0.014) and leg pain relief (p<0.001) and COMI score improvement (p=0.029) than the decompression group. Patient satisfaction was 90% in both groups. No revision was documented in the coflex® and one in the decompression group (2.0%). DISCUSSION In the short-term, lumbar decompression with coflex® compared with decompression alone in patients with LSS and pronounced LBP at baseline is a safe and effective treatment option that appears beneficial regarding clinical and functional outcomes. However, residual confounding of non-measured covariables may have partially influenced our findings. Also, despite careful inclusion and exclusion of cases the cross registry approach introduces a potential for selection bias that we could not totally control for and that makes additional studies necessary.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > Institute for Evaluative Research into Orthopaedic Surgery

UniBE Contributor:

Röder, Christoph and Aghayev, Emin

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0940-6719

Publisher:

Springer

Language:

English

Submitter:

Doris Kopp Heim

Date Deposited:

03 May 2016 13:51

Last Modified:

17 May 2016 14:03

Publisher DOI:

10.1007/s00586-015-4124-6

PubMed ID:

26187621

Uncontrolled Keywords:

Back pain Decompression Dynamic stabilization Interlaminar spacer Lumbar spinal stenosis

BORIS DOI:

10.7892/boris.81904

URI:

https://boris.unibe.ch/id/eprint/81904

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