Interspinous dynamic stabilization adjacent to fusion versus double-segment fusion for treatment of lumbar degenerative disease with a minimum follow-up of three years
Purpose The aim of this study was to assess the outcome of symptomatic lumbar degenerative disease treated with topping-off technique (Coflex ™ combined with fusion) and compare two-segment fusion at mid-long term follow-up; and find out whether the topping-off technique can reduce the rate of adjac...
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| Veröffentlicht in: | International orthopaedics 2016-06, Vol.40 (6), p.1275-1283 |
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| creator | Chen, Xiao-Long Guan, Li Liu, Yu-Zeng Yang, Jin-Cai Wang, Wen-Long Hai, Yong |
| description | Purpose
The aim of this study was to assess the outcome of symptomatic lumbar degenerative disease treated with topping-off technique (Coflex
™
combined with fusion) and compare two-segment fusion at mid-long term follow-up; and find out whether the topping-off technique can reduce the rate of adjacent segment degeneration (ASD) after fusion.
Methods
One hundred and fifty-four consecutive patients who received topping-off surgery (76 patients) and two-segment fusion surgery (88 patients) from March 2009 to March 2012 were studied. All patients included in the analysis had a minimum of three years of follow-up. Radiographic and clinical outcomes between the two groups were compared. A logistic regression analysis was used to analyze risk factors for developing radiographic ASD.
Results
Significant differences in clinical outcomes were observed between these two groups at three post-operative years (all,
p
|
| doi_str_mv | 10.1007/s00264-016-3199-y |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1868306959</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1795860459</sourcerecordid><originalsourceid>FETCH-LOGICAL-c377t-1902ba100ea1e4bd014e0811de54d122ff0e3066ed200a3ad93415b68e3f3e5b3</originalsourceid><addsrcrecordid>eNqFkc1u1DAUhS0EotPCA7BBXrIx-MaJEy9RxU-lSmxgbTnxzdSjxB5sp1V4ob4mTmdgCasr3fOdsziHkDfA3wPn7YfEeSVrxkEyAUqx9RnZQS0q1oBqnpMdFzWwSqrmglymdOAcWtnBS3JRtQCdaOsdebzxGWM6Oh-WRO3qzewGmrLp3eR-meyCp8YezIA-0xzouKTtdV88Gx-WfkKWcD9v-lkcQ6Q5oslPzzDSaZl7E6nFPXqMJfQeqXUJTUL64PIdNXR23s3LXLzTFB7Yctx8-S4i0hVNTK_Ii9FMCV-f7xX58fnT9-uv7Pbbl5vrj7dsEG2bGShe9aaUgwaw7i2HGnkHYLGpLVTVOHIUXEq0FedGGKtKRU0vOxSjwKYXV-TdKfcYw88FU9azSwNOk_FYGtLQya4EqEb9H21V00leP6FwQocYUoo46mN0s4mrBq63KfVpSl2m1NuUei2et-f4pZ_R_nX82a4A1QlIRfJ7jPoQluhLO_9I_Q0VQK5h</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1795860459</pqid></control><display><type>article</type><title>Interspinous dynamic stabilization adjacent to fusion versus double-segment fusion for treatment of lumbar degenerative disease with a minimum follow-up of three years</title><source>MEDLINE</source><source>Springer Nature - Complete Springer Journals</source><source>EZB-FREE-00999 freely available EZB journals</source><creator>Chen, Xiao-Long ; Guan, Li ; Liu, Yu-Zeng ; Yang, Jin-Cai ; Wang, Wen-Long ; Hai, Yong</creator><creatorcontrib>Chen, Xiao-Long ; Guan, Li ; Liu, Yu-Zeng ; Yang, Jin-Cai ; Wang, Wen-Long ; Hai, Yong</creatorcontrib><description>Purpose
The aim of this study was to assess the outcome of symptomatic lumbar degenerative disease treated with topping-off technique (Coflex
™
combined with fusion) and compare two-segment fusion at mid-long term follow-up; and find out whether the topping-off technique can reduce the rate of adjacent segment degeneration (ASD) after fusion.
Methods
One hundred and fifty-four consecutive patients who received topping-off surgery (76 patients) and two-segment fusion surgery (88 patients) from March 2009 to March 2012 were studied. All patients included in the analysis had a minimum of three years of follow-up. Radiographic and clinical outcomes between the two groups were compared. A logistic regression analysis was used to analyze risk factors for developing radiographic ASD.
Results
Significant differences in clinical outcomes were observed between these two groups at three post-operative years (all,
p
< 0.05). Compared with the fusion group, the topping-off group showed preserved mobility at the Coflex
™
level (
p
= 0.000), which is associated with less blood loss (
p
= 0.000), shorter duration of surgery (
p
= 0.000) and lower incidence of ASD (Chi-square test, rate topping-off vs fusion = 13.2 vs 26.1 %,
p
= 0.039). There were no differences in complications between the two groups.
Conclusion
Mid-long term follow-up efficacy and safety between topping-off and fusion were similar, while topping-off reduced the rate of ASD. Under strict indications, topping-off surgery is an acceptable alternative to fusion surgery for the treatment of two-segment lumbar disease.</description><identifier>ISSN: 0341-2695</identifier><identifier>EISSN: 1432-5195</identifier><identifier>DOI: 10.1007/s00264-016-3199-y</identifier><identifier>PMID: 27118374</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Female ; Follow-Up Studies ; Humans ; Logistic Models ; Lumbar Vertebrae - surgery ; Lumbosacral Region ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Original Paper ; Orthopedics ; Postoperative Complications - epidemiology ; Postoperative Period ; Retrospective Studies ; Risk Factors ; Spinal Fusion - adverse effects ; Spinal Fusion - methods ; Treatment Outcome</subject><ispartof>International orthopaedics, 2016-06, Vol.40 (6), p.1275-1283</ispartof><rights>SICOT aisbl 2016</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c377t-1902ba100ea1e4bd014e0811de54d122ff0e3066ed200a3ad93415b68e3f3e5b3</citedby><cites>FETCH-LOGICAL-c377t-1902ba100ea1e4bd014e0811de54d122ff0e3066ed200a3ad93415b68e3f3e5b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00264-016-3199-y$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00264-016-3199-y$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27118374$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chen, Xiao-Long</creatorcontrib><creatorcontrib>Guan, Li</creatorcontrib><creatorcontrib>Liu, Yu-Zeng</creatorcontrib><creatorcontrib>Yang, Jin-Cai</creatorcontrib><creatorcontrib>Wang, Wen-Long</creatorcontrib><creatorcontrib>Hai, Yong</creatorcontrib><title>Interspinous dynamic stabilization adjacent to fusion versus double-segment fusion for treatment of lumbar degenerative disease with a minimum follow-up of three years</title><title>International orthopaedics</title><addtitle>International Orthopaedics (SICOT)</addtitle><addtitle>Int Orthop</addtitle><description>Purpose
The aim of this study was to assess the outcome of symptomatic lumbar degenerative disease treated with topping-off technique (Coflex
™
combined with fusion) and compare two-segment fusion at mid-long term follow-up; and find out whether the topping-off technique can reduce the rate of adjacent segment degeneration (ASD) after fusion.
Methods
One hundred and fifty-four consecutive patients who received topping-off surgery (76 patients) and two-segment fusion surgery (88 patients) from March 2009 to March 2012 were studied. All patients included in the analysis had a minimum of three years of follow-up. Radiographic and clinical outcomes between the two groups were compared. A logistic regression analysis was used to analyze risk factors for developing radiographic ASD.
Results
Significant differences in clinical outcomes were observed between these two groups at three post-operative years (all,
p
< 0.05). Compared with the fusion group, the topping-off group showed preserved mobility at the Coflex
™
level (
p
= 0.000), which is associated with less blood loss (
p
= 0.000), shorter duration of surgery (
p
= 0.000) and lower incidence of ASD (Chi-square test, rate topping-off vs fusion = 13.2 vs 26.1 %,
p
= 0.039). There were no differences in complications between the two groups.
Conclusion
Mid-long term follow-up efficacy and safety between topping-off and fusion were similar, while topping-off reduced the rate of ASD. Under strict indications, topping-off surgery is an acceptable alternative to fusion surgery for the treatment of two-segment lumbar disease.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Logistic Models</subject><subject>Lumbar Vertebrae - surgery</subject><subject>Lumbosacral Region</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Original Paper</subject><subject>Orthopedics</subject><subject>Postoperative Complications - epidemiology</subject><subject>Postoperative Period</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Spinal Fusion - adverse effects</subject><subject>Spinal Fusion - methods</subject><subject>Treatment Outcome</subject><issn>0341-2695</issn><issn>1432-5195</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkc1u1DAUhS0EotPCA7BBXrIx-MaJEy9RxU-lSmxgbTnxzdSjxB5sp1V4ob4mTmdgCasr3fOdsziHkDfA3wPn7YfEeSVrxkEyAUqx9RnZQS0q1oBqnpMdFzWwSqrmglymdOAcWtnBS3JRtQCdaOsdebzxGWM6Oh-WRO3qzewGmrLp3eR-meyCp8YezIA-0xzouKTtdV88Gx-WfkKWcD9v-lkcQ6Q5oslPzzDSaZl7E6nFPXqMJfQeqXUJTUL64PIdNXR23s3LXLzTFB7Yctx8-S4i0hVNTK_Ii9FMCV-f7xX58fnT9-uv7Pbbl5vrj7dsEG2bGShe9aaUgwaw7i2HGnkHYLGpLVTVOHIUXEq0FedGGKtKRU0vOxSjwKYXV-TdKfcYw88FU9azSwNOk_FYGtLQya4EqEb9H21V00leP6FwQocYUoo46mN0s4mrBq63KfVpSl2m1NuUei2et-f4pZ_R_nX82a4A1QlIRfJ7jPoQluhLO_9I_Q0VQK5h</recordid><startdate>20160601</startdate><enddate>20160601</enddate><creator>Chen, Xiao-Long</creator><creator>Guan, Li</creator><creator>Liu, Yu-Zeng</creator><creator>Yang, Jin-Cai</creator><creator>Wang, Wen-Long</creator><creator>Hai, Yong</creator><general>Springer Berlin Heidelberg</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>7QP</scope></search><sort><creationdate>20160601</creationdate><title>Interspinous dynamic stabilization adjacent to fusion versus double-segment fusion for treatment of lumbar degenerative disease with a minimum follow-up of three years</title><author>Chen, Xiao-Long ; Guan, Li ; Liu, Yu-Zeng ; Yang, Jin-Cai ; Wang, Wen-Long ; Hai, Yong</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c377t-1902ba100ea1e4bd014e0811de54d122ff0e3066ed200a3ad93415b68e3f3e5b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Logistic Models</topic><topic>Lumbar Vertebrae - surgery</topic><topic>Lumbosacral Region</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Original Paper</topic><topic>Orthopedics</topic><topic>Postoperative Complications - epidemiology</topic><topic>Postoperative Period</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Spinal Fusion - adverse effects</topic><topic>Spinal Fusion - methods</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chen, Xiao-Long</creatorcontrib><creatorcontrib>Guan, Li</creatorcontrib><creatorcontrib>Liu, Yu-Zeng</creatorcontrib><creatorcontrib>Yang, Jin-Cai</creatorcontrib><creatorcontrib>Wang, Wen-Long</creatorcontrib><creatorcontrib>Hai, Yong</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>Calcium & Calcified Tissue Abstracts</collection><jtitle>International orthopaedics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chen, Xiao-Long</au><au>Guan, Li</au><au>Liu, Yu-Zeng</au><au>Yang, Jin-Cai</au><au>Wang, Wen-Long</au><au>Hai, Yong</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Interspinous dynamic stabilization adjacent to fusion versus double-segment fusion for treatment of lumbar degenerative disease with a minimum follow-up of three years</atitle><jtitle>International orthopaedics</jtitle><stitle>International Orthopaedics (SICOT)</stitle><addtitle>Int Orthop</addtitle><date>2016-06-01</date><risdate>2016</risdate><volume>40</volume><issue>6</issue><spage>1275</spage><epage>1283</epage><pages>1275-1283</pages><issn>0341-2695</issn><eissn>1432-5195</eissn><abstract>Purpose
The aim of this study was to assess the outcome of symptomatic lumbar degenerative disease treated with topping-off technique (Coflex
™
combined with fusion) and compare two-segment fusion at mid-long term follow-up; and find out whether the topping-off technique can reduce the rate of adjacent segment degeneration (ASD) after fusion.
Methods
One hundred and fifty-four consecutive patients who received topping-off surgery (76 patients) and two-segment fusion surgery (88 patients) from March 2009 to March 2012 were studied. All patients included in the analysis had a minimum of three years of follow-up. Radiographic and clinical outcomes between the two groups were compared. A logistic regression analysis was used to analyze risk factors for developing radiographic ASD.
Results
Significant differences in clinical outcomes were observed between these two groups at three post-operative years (all,
p
< 0.05). Compared with the fusion group, the topping-off group showed preserved mobility at the Coflex
™
level (
p
= 0.000), which is associated with less blood loss (
p
= 0.000), shorter duration of surgery (
p
= 0.000) and lower incidence of ASD (Chi-square test, rate topping-off vs fusion = 13.2 vs 26.1 %,
p
= 0.039). There were no differences in complications between the two groups.
Conclusion
Mid-long term follow-up efficacy and safety between topping-off and fusion were similar, while topping-off reduced the rate of ASD. Under strict indications, topping-off surgery is an acceptable alternative to fusion surgery for the treatment of two-segment lumbar disease.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>27118374</pmid><doi>10.1007/s00264-016-3199-y</doi><tpages>9</tpages></addata></record> |
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| ispartof | International orthopaedics, 2016-06, Vol.40 (6), p.1275-1283 |
| issn | 0341-2695 1432-5195 |
| language | eng |
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| source | MEDLINE; Springer Nature - Complete Springer Journals; EZB-FREE-00999 freely available EZB journals |
| subjects | Adult Aged Aged, 80 and over Female Follow-Up Studies Humans Logistic Models Lumbar Vertebrae - surgery Lumbosacral Region Male Medicine Medicine & Public Health Middle Aged Original Paper Orthopedics Postoperative Complications - epidemiology Postoperative Period Retrospective Studies Risk Factors Spinal Fusion - adverse effects Spinal Fusion - methods Treatment Outcome |
| title | Interspinous dynamic stabilization adjacent to fusion versus double-segment fusion for treatment of lumbar degenerative disease with a minimum follow-up of three years |
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