Decompression and coflex interlaminar stabilisation compared with conventional surgical procedures for lumbar spinal stenosis: A systematic review and meta-analysis

Li, Aimin; Li, Xiang; Yang, Zhong

doi:10.1016/j.ijsu.2017.02.056

Cited by 18 publications

(15 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Similar to our findings, Li et al concluded that D+F showed less favorable outcomes in terms of ODI, length of hospital stay, and blood loss in comparison with D alone (using coflex). They did not find any significant difference in VAS and major device-related complications, which is in contrast to our findings [ 24 ]. Another international study showed that both the D and D+F groups resulted in reduced VAS LP and BP [ 25 ].…”

Section: Reviewcontrasting

confidence: 99%

Comparison of Decompression Alone Versus Decompression with Fusion for Stenotic Lumbar Spine: A Systematic Review and Meta-analysis

Ahmed

Javed

Bareeqa

et al. 2018

Cureus

View full text Add to dashboard Cite

The first line of treatment for lumbar spinal stenosis (with or without lumbar degenerative spondylolisthesis) involves conservative options such as anti-inflammatory drugs and analgesics. Approximately, 10%-15% of patients require surgery. Surgical treatment aims to decompress the spinal canal and dural sac from degenerative bony and ligamentous overgrowth. Different studies have given conflicting results. The aim of our study is to clear the confusion by comparing two surgical techniques. This meta-analysis was conducted in accordance with the preferred reporting items for systematic reviews and meta-analysis (PRISMA) guidelines. A literature search was conducted of the Ovid Embase, Scopus, Pubmed, Ovid Medline, Google Scholar, and Cochrane library databases. A quality and risk of bias assessment was also done. The analysis was done using Revman software (The Nordic Cochrane Centre, The Cochrane Collaboration, 2014, Copenhagen, Denmark).A total of 76 studies were extracted from the literature search and 29 studies with relevant information were shortlisted. Nine studies were included in the meta-analysis after a quality assessment and eligibility. Fusion with decompression surgery was found to be a better technique when compared to decompression alone for spinal stenosis in terms of the Oswestry Disability index and the visual analog pain scale for back and leg pain. On the basis of the meta-analysis of the recent medical literature, the authors concluded that decompression with fusion is a 3.5-times better surgical technique than decompression alone for spinal stenosis.

show abstract

Section: Reviewcontrasting

confidence: 99%

Comparison of Decompression Alone Versus Decompression with Fusion for Stenotic Lumbar Spine: A Systematic Review and Meta-analysis

Ahmed

Javed

Bareeqa

et al. 2018

Cureus

View full text Add to dashboard Cite

show abstract

“…A recent study by Bae et al also compared decompression and ILS to decompression and instrumented spinal fusion; CCS rates for patients treated with ILS were shown to be statistically superior, demonstrating the benefits of ILS in terms of durability [8]. However, regarding complications associated with ILS, similar rates were seen in both decompression with fusion and decompression with ILS [15]. Randomized prospective trials with a longer follow-up duration are needed to evaluate outcomes and device-related complications.…”

Section: Discussionmentioning

confidence: 99%

Lumbar Facet Joint Cyst Treated With Decompression and Interlaminar Stabilization

Sagoo

Bhatti²,

Rowe

et al. 2020

Cureus

View full text Add to dashboard Cite

Spinal facet joint cysts (FJCs) are an increasingly reported cause of lower back pain, radiculopathy, and neurological deficits owing to their proximity to adjacent nerve roots. The etiology of these cysts has not yet been fully elucidated, although they appear to be related to degenerative changes in the facet joints themselves. Conservative management strategies including physical therapy and oral analgesics rarely result in spontaneous regression of an FJC, often providing only short-term relief. The current treatment modalities reported for FJCs generally range from percutaneous cyst aspiration to decompression surgery with or without instrumented spinal fusion. However, instrumented fusion often results in a higher rate of complications such as pseudoarthrosis and adjacent segment disease. The Coflex ® (Paradigm Spine, LLC, New York, NY) interlaminar stabilization (ILS) implant is a novel titanium, Ushaped device which acts as a motion-preserving stabilizer and has proven to be a viable alternative to instrumental fusion. Here, we discuss a case of an FJC treated with both decompression and placement of a Coflex ILS device.

show abstract

“…The distraction force also enlarged the intervertebral foramen and reduced the load on the intervertebral disc and the facet joint in flexion. The meta-analysis by Ai-min Li [27] showed that Coflex was more effective than PLIF in terms of decompression, the Oswestry Disability Index (ODI), length of hospital stay (LOS) and blood loss. Wei yuan [28] held that Coflex surgery had significantly less blood loss, shorter hospital stay and operative time than PLIF (p < 0.001), and it also had a lower reoperation rate for ASD than PLIF, yet with no statistical difference (11.1% vs. 4.8%, p = 0.277).…”

Section: Discussionmentioning

confidence: 99%

Topping-off surgery vs posterior lumbar interbody fusion for degenerative lumbar disease: a finite element analysis

Fan¹,

Zhu

2019

Preprint

View full text Add to dashboard Cite

Background Adjacent segment disease (ASD) is a common complication after posterior lumbar interbody fusion (PLIF). Recently, a topping-off surgery (non-fusion with Coflex) has been developed to reduce the risk of ASD, yet whether and how the topping-off surgery can relieve ASD remains unclear. The purpose of this study was to explore the biomechanical effect of PLIF and Coflex on the adjacent segments via finite element (FE) analysis and discuss the efficacy of Coflex in preventing ASD.Methods A FE model of L3-5 segments was generated from the CT of a healthy volunteer via three commercially available software. Coflex and PLIF devices were modeled and implanted with the segment model in the FE software. In the FE model, a pre-compressive load of 500 N, which was equal to two thirds of the human body mass, was applied to the top surface of the L3. In addition, four types of moments (anteﬂexion, rear protraction, bending and axial rotation) set as 10 Nm were successively applied to the FE model combined with this pre-compressive load. Then the range of motion (ROM), the torsional rigidity and the maximum von Mises equivalent stress on L3-L4 disc and the implant were analyzed.Results Both Coflex and PLIF reduced ROM. However, no significant difference was found in the maximum von Mises equivalent stress of adjacent segment disc between the two devices. Interestingly enough, both systems increased the torsional rigidity at the adjacent lumbar segment, and PLIF had a more significant increase. The Coflex implant had a larger maximum von Mises equivalent stress.Conclusions Both Coflex and PLIF reduced ROM at L3-L4, and thus improved the lumbar stability. Under the same load, both devices had almost the same maximum von Mises equivalent stress as the normal model on the adjacent intervertebral disc. But it is worthy to notice the torsional rigidity of PLIF was higher than that of Coflex. It indicated that the lumbar treated with PLIF would undertake a larger load to reach ROM of Coflex. Therefore, we presumed that ADS was related to higher torsional rigidity.

show abstract

Decompression and coflex interlaminar stabilisation compared with conventional surgical procedures for lumbar spinal stenosis: A systematic review and meta-analysis

Cited by 18 publications

References 27 publications

Comparison of Decompression Alone Versus Decompression with Fusion for Stenotic Lumbar Spine: A Systematic Review and Meta-analysis

Comparison of Decompression Alone Versus Decompression with Fusion for Stenotic Lumbar Spine: A Systematic Review and Meta-analysis

Lumbar Facet Joint Cyst Treated With Decompression and Interlaminar Stabilization

Topping-off surgery vs posterior lumbar interbody fusion for degenerative lumbar disease: a finite element analysis

Contact Info

Product

Resources

About