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15-year survivorship analysis of an interspinous device in surgery for single-level lumbar disc herniation

BACKGROUND: Interspinous devices have been introduced as alternatives to decompression or fusion in surgery for degenerative lumbar diseases. This study aimed to investigate 15-year survivorship and risk factors for reoperation of a Device for Intervertebral Assisted Motion (DIAM) in surgery for 1-l...

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Autores principales: Cho, Yoon Joo, Park, Jong-Beom, Chang, Dong-Gune, Kim, Hong Jin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8656107/
https://www.ncbi.nlm.nih.gov/pubmed/34886816
http://dx.doi.org/10.1186/s12891-021-04929-8
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author Cho, Yoon Joo
Park, Jong-Beom
Chang, Dong-Gune
Kim, Hong Jin
author_facet Cho, Yoon Joo
Park, Jong-Beom
Chang, Dong-Gune
Kim, Hong Jin
author_sort Cho, Yoon Joo
collection PubMed
description BACKGROUND: Interspinous devices have been introduced as alternatives to decompression or fusion in surgery for degenerative lumbar diseases. This study aimed to investigate 15-year survivorship and risk factors for reoperation of a Device for Intervertebral Assisted Motion (DIAM) in surgery for 1-level lumbar disc herniation (LDH). METHODS: A total of 94 patients (54 men and 40 women) underwent discectomy and DIAM implantation for 1-level LDH, with a mean follow-up of 12.9 years (range, 6.3–15.3 years). The mean age was 46.2 years (range, 21–65 years). Sixty-two patients underwent DIAM implantation for L4–5, 27 for L5–6, and 5 for L3–4. Reoperations due to any reason associated with DIAM implantation level or adjacent levels were defined as failure and used as the end point of determining survivorship. RESULTS: During the 15-year follow-up, 8 patients (4 men and 4 women) underwent reoperation due to recurrence of LDH at the DIAM implantation level, a reoperation rate of 8.5%. The mean time to reoperation was 6.5 years (range, 0.8–13.9 years). Kaplan-Meier analysis showed a cumulative survival rate of the DIAM implantation of 97% at 5 years, 93% at 10 years, and 92% at 15 years after surgery; the cumulative reoperation rate of the DIAM implantation was 3% at 5 years, 7% at 10 years, and 8% at 15 years after surgery. Mean survival time was predicted to be 14.5 years (95% CI, 13.97–15.07). The log-rank test and Cox proportional hazard model showed that age, sex, and location did not significantly affect the reoperation rate of DIAM implantation. CONCLUSIONS: Our results showed that DIAM implantation significantly decreased reoperation rate for LDH in the 15-year survivorship analysis. We suggest that DIAM implantation could be considered a useful intermediate step procedure for LDH surgery. To the best of our knowledge, this is the longest follow-up study in which surgical outcomes of interspinous device surgery were reported.
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spelling pubmed-86561072021-12-10 15-year survivorship analysis of an interspinous device in surgery for single-level lumbar disc herniation Cho, Yoon Joo Park, Jong-Beom Chang, Dong-Gune Kim, Hong Jin BMC Musculoskelet Disord Research BACKGROUND: Interspinous devices have been introduced as alternatives to decompression or fusion in surgery for degenerative lumbar diseases. This study aimed to investigate 15-year survivorship and risk factors for reoperation of a Device for Intervertebral Assisted Motion (DIAM) in surgery for 1-level lumbar disc herniation (LDH). METHODS: A total of 94 patients (54 men and 40 women) underwent discectomy and DIAM implantation for 1-level LDH, with a mean follow-up of 12.9 years (range, 6.3–15.3 years). The mean age was 46.2 years (range, 21–65 years). Sixty-two patients underwent DIAM implantation for L4–5, 27 for L5–6, and 5 for L3–4. Reoperations due to any reason associated with DIAM implantation level or adjacent levels were defined as failure and used as the end point of determining survivorship. RESULTS: During the 15-year follow-up, 8 patients (4 men and 4 women) underwent reoperation due to recurrence of LDH at the DIAM implantation level, a reoperation rate of 8.5%. The mean time to reoperation was 6.5 years (range, 0.8–13.9 years). Kaplan-Meier analysis showed a cumulative survival rate of the DIAM implantation of 97% at 5 years, 93% at 10 years, and 92% at 15 years after surgery; the cumulative reoperation rate of the DIAM implantation was 3% at 5 years, 7% at 10 years, and 8% at 15 years after surgery. Mean survival time was predicted to be 14.5 years (95% CI, 13.97–15.07). The log-rank test and Cox proportional hazard model showed that age, sex, and location did not significantly affect the reoperation rate of DIAM implantation. CONCLUSIONS: Our results showed that DIAM implantation significantly decreased reoperation rate for LDH in the 15-year survivorship analysis. We suggest that DIAM implantation could be considered a useful intermediate step procedure for LDH surgery. To the best of our knowledge, this is the longest follow-up study in which surgical outcomes of interspinous device surgery were reported. BioMed Central 2021-12-09 /pmc/articles/PMC8656107/ /pubmed/34886816 http://dx.doi.org/10.1186/s12891-021-04929-8 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Cho, Yoon Joo
Park, Jong-Beom
Chang, Dong-Gune
Kim, Hong Jin
15-year survivorship analysis of an interspinous device in surgery for single-level lumbar disc herniation
title 15-year survivorship analysis of an interspinous device in surgery for single-level lumbar disc herniation
title_full 15-year survivorship analysis of an interspinous device in surgery for single-level lumbar disc herniation
title_fullStr 15-year survivorship analysis of an interspinous device in surgery for single-level lumbar disc herniation
title_full_unstemmed 15-year survivorship analysis of an interspinous device in surgery for single-level lumbar disc herniation
title_short 15-year survivorship analysis of an interspinous device in surgery for single-level lumbar disc herniation
title_sort 15-year survivorship analysis of an interspinous device in surgery for single-level lumbar disc herniation
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8656107/
https://www.ncbi.nlm.nih.gov/pubmed/34886816
http://dx.doi.org/10.1186/s12891-021-04929-8
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