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Five-year radiological outcomes between decompression alone and decompression with an interlaminar device for lumbar
Chen Xi Kasia Chua1, Meetrra Seyher Rajoo1, Andrew Cherian Thomas1
1Department of Orthopaedic Surgery, National University Health System, Singapore, Singapore.
Journal of Spine Surgery (Hong Kong)
|October 14, 2024
Summary
Interlaminar devices (ILDs) used with decompression for lumbar spinal stenosis (LSS) improved disc and foraminal height over 5 years compared to decompression alone (DA). While sagittal balance remained unchanged, ILDs showed better mental health outcomes.
Area of Science:
- Spine surgery
- Orthopedic research
- Radiological outcomes
Background:
- Limited literature exists on 5-year radiological outcomes of interlaminar devices (ILDs) as adjuncts to decompression for lumbar spinal stenosis (LSS).
- Comparing ILDs with decompression alone (DA) is crucial for understanding treatment efficacy.
Purpose of the Study:
- To assess and compare 5-year radiological outcomes of spinal decompression with ILD insertion (D + ILD) versus decompression alone (DA) for symptomatic LSS.
Main Methods:
- Retrospective review of prospectively collected data from 94 LSS patients (2007-2015).
- Patients were divided into D + ILD (n=39) and DA (n=55) groups.
- Radiological indices assessed preoperatively, immediately post-op, and at 2 and 5 years.
Main Results:
- No significant change in sagittal balance parameters (pelvic incidence, tilt, sacral slope, PI-LL) in either group over 5 years.
- D + ILD group showed significant increases in anterior disc (1.3 mm), posterior disc (1.8 mm), and foraminal height (4.7 mm) compared to DA.
- D + ILD group demonstrated significant improvement in mental component summary (SF36 MCS) scores (P=0.01), with equivalent reoperation rates.
Conclusions:
- Adjunct ILD use in LSS management significantly improves disc and foraminal height over 5 years compared to DA.
- Focal kyphosis at the intervention level is observed with ILDs, without affecting overall lumbar lordosis or sagittal balance.
- ILDs offer potential benefits in radiological parameters and mental health outcomes for LSS patients.
