Orthobiologic Supplementation Improves Clinical Outcomes Following Lumbar Decompression Surgery

Area of Science:

• Orthopedic Surgery
• Regenerative Medicine
• Spine Surgery

Background:

• Endoscopic-assisted lumbar decompression is a minimally invasive spine surgery aiming to reduce tissue damage and improve recovery.
• Common post-operative issues include residual pain and recurrent herniation.
• Orthobiologics, such as amniotic-derived products (ADPs) and bone marrow aspiration (BMA), are being explored to enhance surgical outcomes.

Purpose of the Study:

• To compare patient outcomes following endoscopic-assisted lumbar decompression surgery with orthobiologic supplementation.
• To evaluate the efficacy of ADPs and BMA in improving post-operative recovery.

Main Methods:

• A randomized controlled trial involving 269 patients undergoing endoscopic-assisted lumbar decompression surgery.
• Patients were randomized into four groups: ADP, BMA, both, or no supplementation (control).
• Outcomes were assessed using the Visual Analog Scale (VAS), Oswestry Disability Index (ODI), and SF-36 survey over 12 months.

Main Results:

• Both BMA and ADP groups showed statistically significant improvements in leg pain (VAS-leg) at 2 weeks, 6 months, and 9 months compared to the control group.
• Significant improvements in back pain (VAS-back) were observed at multiple time points for BMA and ADP groups versus control.
• While initial differences in ODI and SF-36 scores were noted, they did not persist over the 12-month follow-up period. Two patients experienced re-herniation.

Conclusions:

• Orthobiologic treatments, specifically BMA and ADP, demonstrated effectiveness in improving pain control during the early post-operative phase after lumbar decompression.
• Further research may be warranted to assess long-term benefits and optimal application strategies for these orthobiologics in spine surgery.