Document Detail

Fusion rates and SF-36 outcomes after multilevel laminectomy and noninstrumented lumbar fusions in a predominantly geriatric population.
MedLine Citation:
PMID:  18458584     Owner:  NLM     Status:  MEDLINE    
STUDY DESIGN: This study prospectively analyzed posterolateral fusion rates and Short-Form 36 (SF-36) outcomes after multilevel lumbar laminectomies and noninstrumented fusions. OBJECTIVE: SF-36 outcomes and posterolateral fusion rates were assessed. SUMMARY OF BACKGROUND DATA: Technologically advanced and expensive instrumentation techniques and fusion adjuncts (ie, bone morphogenetic protein) may not be necessary to achieve lumbar fusion in the geriatric population. Rather, noninstrumented fusions using lamina autograft and a bone volume expander may suffice. METHODS: Seventy-five patients averaging 69 years of age (49 females, 26 males) underwent average 4.9 level lumbar laminectomies with average 2.0 level noninstrumented posterolateral fusions using lamina autograft (average 30 cm) supplemented with demineralized bone matrix (average 30 cm) in a 50:50 mix. Two independent radiologists separately evaluated both 2-dimensional computed tomography (2D-CT) and dynamic x-ray data 3, 4.5, 6, and up to 12 months postoperatively; patients had to demonstrate fusion on both studies. Outcomes were assessed using the SF-36 questionnaire (preoperatively) 3, 6, 12, and 24 months postoperatively. Patients were followed an average of 3.3 years (minimum 2 y). RESULTS: Thirteen (17.3%) patients demonstrated pseudarthrosis as they had not fused on dynamic x-ray and/or 2D-CT studies an average of 5.6 months postoperatively. One patient required a secondary fusion. One and 2 years postoperatively, patients demonstrated nearly identical maximal improvement on 6 SF-36 Health Scales, but showed no real changes on General Health and Mental Health scales. CONCLUSIONS: Seventy-five predominantly geriatric patients underwent multilevel laminectomies with noninstrumented fusions using lamina autograft combined with a bone volume expander. Thirteen patients (17.3%) demonstrated pseudarthrosis on the basis of both dynamic x-ray and 2D-CT criteria; 1 patient required a second instrumented fusion. Moderate pseudarthrosis rates, a low reoperation rate, and satisfactory SF-36 outcomes were achieved using noninstrumented posterolateral fusions in a predominantly geriatric population.
Nancy E Epstein
Related Documents :
20844454 - Significance of angular mismatch between vertebral endplate and prosthetic endplate in ...
15864014 - Augmentation of third generation instrumentation with sublaminar titanium wiring in lat...
19494744 - Coronal and sagittal plane correction in patients with lenke 1 adolescent idiopathic sc...
20110834 - Clinical efficacy of the vertebral wedge osteotomy for the fusionless treatment of para...
24139754 - The role of ultrasound-guided triamcinolone injection in the treatment of de quervain's...
11344394 - Outcome of surgical intervention for rectoneovaginal fistulas in mayer-rokitansky-kuest...
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of spinal disorders & techniques     Volume:  21     ISSN:  1536-0652     ISO Abbreviation:  J Spinal Disord Tech     Publication Date:  2008 May 
Date Detail:
Created Date:  2008-05-09     Completed Date:  2008-07-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101140323     Medline TA:  J Spinal Disord Tech     Country:  United States    
Other Details:
Languages:  eng     Pagination:  159-64     Citation Subset:  IM    
The Albert Einstein College of Medicine, Bronx, NY, USA.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Aged, 80 and over
Bone Matrix / transplantation*
Laminectomy / instrumentation,  methods*
Lumbar Vertebrae / radiography,  surgery*
Middle Aged
Prospective Studies
Spinal Diseases / radiography,  surgery*
Tomography, X-Ray Computed
Transplantation, Autologous
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  Radiographic predictors of residual low back pain after laminectomy for lumbar spinal canal stenosis...
Next Document:  Long-term biomechanical stability and clinical improvement after extended multilevel corpectomy and ...