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Soft Stabilization With an Artificial Intervertebral Ligament in Grade I Degenerative Spondylolisthesis: Comparison With Instrumented Posterior Lumbar Interbody Fusion

BACKGROUND: The purpose of this retrospective study was to evaluate the efficacy of soft stabilization with an artificial intervertebral ligament after microdecompression for the treatment of grade I degenerative spondylolisthesis. METHODS: From a total of 54 patients with degenerative spondylolisth...

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Autores principales: Shim, Chan Shik, Lee, Sang-Ho, Park, Sun-Hee, Whang, Ji-Hee
Formato: Online Artículo Texto
Lenguaje:English
Publicado: RRY Publications, LLC 2007
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4365580/
https://www.ncbi.nlm.nih.gov/pubmed/25802588
http://dx.doi.org/10.1016/SASJ-2006-0006-RR
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author Shim, Chan Shik
Lee, Sang-Ho
Park, Sun-Hee
Whang, Ji-Hee
author_facet Shim, Chan Shik
Lee, Sang-Ho
Park, Sun-Hee
Whang, Ji-Hee
author_sort Shim, Chan Shik
collection PubMed
description BACKGROUND: The purpose of this retrospective study was to evaluate the efficacy of soft stabilization with an artificial intervertebral ligament after microdecompression for the treatment of grade I degenerative spondylolisthesis. METHODS: From a total of 54 patients with degenerative spondylolisthesis who were treated surgically from May 2000 to April 2003, 36 patients who showed grade I spondylolisthesis without evidence of concomitant disc herniation necessitating discectomy were enrolled in the study. After decompression, the patients had undergone either soft stabilization with an artificial intervertebral ligament (n = 17) or instrumented posterior lumbar interbody fusion (PLIF; n = 19). RESULTS: The average follow-up period was 24 months for the PLIF group and 16 months for the soft stabilization group. In the PLIF group, preoperative mean scores of 60% on the Oswestry Disability Index, 8.8 on the visual analog scale (VAS) for low-back pain, and 9.3 on the VAS for leg pain improved to 28%, 4.1, and 2.6, respectively, after surgery. Corresponding scores in the soft stabilization group were 55%, 8.4, and 8.9, improving to 25%, 4.1, and 2.2 after surgery. There were no significant differences between the 2 groups in any of these clinical parameters. Patients’ subjective improvement rates and satisfaction with the surgical procedure were higher in the soft stabilization group, but the differences were not significant. Mean operation time and mean blood loss were significantly lower in the soft stabilization group than in the PLIF group. In the soft stabilization group, there were 3 cases of progression of slippage in patients who had had preoperative slippage of more than 20%; there was 1 dural tear in the PLIF group. CONCLUSIONS: Patients with grade I degenerative spondylolisthesis who received soft stabilization with an artificial intervertebral ligament after microdecompression had clinical outcomes similar to those of patients who received PLIF. Since soft stabilization can be done in a much less invasive way than fusion, if slippage is 20% or less, soft stabilization with an artificial ligament is a viable alternative to fusion for patients who are elderly or who have significant comorbidities that make a prolonged operation inadvisable. LEVEL OF EVIDENCE: This study was a retrospective comparative study with a very limited population (level III evidence).
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spelling pubmed-43655802015-03-23 Soft Stabilization With an Artificial Intervertebral Ligament in Grade I Degenerative Spondylolisthesis: Comparison With Instrumented Posterior Lumbar Interbody Fusion Shim, Chan Shik Lee, Sang-Ho Park, Sun-Hee Whang, Ji-Hee SAS J Full Length Article BACKGROUND: The purpose of this retrospective study was to evaluate the efficacy of soft stabilization with an artificial intervertebral ligament after microdecompression for the treatment of grade I degenerative spondylolisthesis. METHODS: From a total of 54 patients with degenerative spondylolisthesis who were treated surgically from May 2000 to April 2003, 36 patients who showed grade I spondylolisthesis without evidence of concomitant disc herniation necessitating discectomy were enrolled in the study. After decompression, the patients had undergone either soft stabilization with an artificial intervertebral ligament (n = 17) or instrumented posterior lumbar interbody fusion (PLIF; n = 19). RESULTS: The average follow-up period was 24 months for the PLIF group and 16 months for the soft stabilization group. In the PLIF group, preoperative mean scores of 60% on the Oswestry Disability Index, 8.8 on the visual analog scale (VAS) for low-back pain, and 9.3 on the VAS for leg pain improved to 28%, 4.1, and 2.6, respectively, after surgery. Corresponding scores in the soft stabilization group were 55%, 8.4, and 8.9, improving to 25%, 4.1, and 2.2 after surgery. There were no significant differences between the 2 groups in any of these clinical parameters. Patients’ subjective improvement rates and satisfaction with the surgical procedure were higher in the soft stabilization group, but the differences were not significant. Mean operation time and mean blood loss were significantly lower in the soft stabilization group than in the PLIF group. In the soft stabilization group, there were 3 cases of progression of slippage in patients who had had preoperative slippage of more than 20%; there was 1 dural tear in the PLIF group. CONCLUSIONS: Patients with grade I degenerative spondylolisthesis who received soft stabilization with an artificial intervertebral ligament after microdecompression had clinical outcomes similar to those of patients who received PLIF. Since soft stabilization can be done in a much less invasive way than fusion, if slippage is 20% or less, soft stabilization with an artificial ligament is a viable alternative to fusion for patients who are elderly or who have significant comorbidities that make a prolonged operation inadvisable. LEVEL OF EVIDENCE: This study was a retrospective comparative study with a very limited population (level III evidence). RRY Publications, LLC 2007-08-01 /pmc/articles/PMC4365580/ /pubmed/25802588 http://dx.doi.org/10.1016/SASJ-2006-0006-RR Text en Copyright SAS - Spine Arthroplasty Society 2007 http://creativecommons.org/licenses/by-nc-nd/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-Noncommercial 3.0 Unported License, permitting all non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Full Length Article
Shim, Chan Shik
Lee, Sang-Ho
Park, Sun-Hee
Whang, Ji-Hee
Soft Stabilization With an Artificial Intervertebral Ligament in Grade I Degenerative Spondylolisthesis: Comparison With Instrumented Posterior Lumbar Interbody Fusion
title Soft Stabilization With an Artificial Intervertebral Ligament in Grade I Degenerative Spondylolisthesis: Comparison With Instrumented Posterior Lumbar Interbody Fusion
title_full Soft Stabilization With an Artificial Intervertebral Ligament in Grade I Degenerative Spondylolisthesis: Comparison With Instrumented Posterior Lumbar Interbody Fusion
title_fullStr Soft Stabilization With an Artificial Intervertebral Ligament in Grade I Degenerative Spondylolisthesis: Comparison With Instrumented Posterior Lumbar Interbody Fusion
title_full_unstemmed Soft Stabilization With an Artificial Intervertebral Ligament in Grade I Degenerative Spondylolisthesis: Comparison With Instrumented Posterior Lumbar Interbody Fusion
title_short Soft Stabilization With an Artificial Intervertebral Ligament in Grade I Degenerative Spondylolisthesis: Comparison With Instrumented Posterior Lumbar Interbody Fusion
title_sort soft stabilization with an artificial intervertebral ligament in grade i degenerative spondylolisthesis: comparison with instrumented posterior lumbar interbody fusion
topic Full Length Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4365580/
https://www.ncbi.nlm.nih.gov/pubmed/25802588
http://dx.doi.org/10.1016/SASJ-2006-0006-RR
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