Interlaminar stabilization may have edge in elderly with lumbar stenosis
Reuters Health discusses the findings of an HSS study published in The Spine Journal by Celeste Abjornson PhD, director of the Integrated Spine Research Program (ISRP), which found Interlaminar stabilization (ILS), may offer relief in older patients with low-back pain when conservative treatment fails.
"ILS offers a durable, minimally invasive technique to improve clinical outcomes over the classical standard of decompression,” noted Dr. Abjornson. "Similar to an instrumented fusion, ILS provides sustained relief of the neural elements, however it also offers motion preservation that can have significant benefits to the global spinal segment," she added.
In a post-hoc analysis of data from the IDE trial, Dr. Abjornson and colleagues studied patients with moderate lumbar stenosis who had been randomized 2:1 to decompression with ILS or with posterolateral fusion with bilateral pedicle screw instrumentation. Overall, 215 patients had ILS (including 84 who were at least 65 years old) and 107 had fusion (including 57 who were aged 65 or older). Preoperatively all had reported significant pain and disability. They were assessed before and six weeks after surgery and at intervals of up to 60 months. At 24 and 60 months, there were no significant differences in measures of overall clinical success across groups. This was also true of radiographic findings and postoperative narcotic usage. Moreover, there were no statistically significant differences regarding patient satisfaction and patient recommendation of the same treatment. However, older patients who underwent ILS rather than fusion had a shorter mean operative time (100 vs. 153 minutes), a lower estimated mean blood loss (106 vs. 358 cc) and a shorter mean hospital stay (2.07 vs. 3.30 days), all significant differences. When compared with the younger ILS patients, the older ILS group had a significantly longer mean hospital stay, but there were no significant differences in mean operative time or estimated blood loss.
Read the full article at MDalert.com.