Our Summary

This research paper is about a study that compared different surgical procedures used to treat degenerative diseases of the lower spine. The study compared a procedure called posterior lumbar interbody fusion with three other procedures that use devices named Coflex, Wallis, and X-stop.

The researchers wanted to find out which of these procedures was the most effective and safest. They did this by analyzing data from previous studies, which included a total of 2241 patients.

The analysis found that all four procedures were equally effective at relieving pain, improving the patients’ quality of life, and restoring function and height to the intervertebral disc space. However, the three procedures that used devices (Coflex, Wallis, and X-stop) allowed for a greater range of motion in the surgical area compared to posterior lumbar interbody fusion.

The study concluded that while all four procedures were equally effective, the three device procedures might lead to lower rates of adjacent segment degeneration, a common complication of spine surgery where the sections of the spine above and below the treated area start to break down.

FAQs

  1. What surgical procedures were compared in the study for treating degenerative diseases of the lower spine?
  2. What was the main difference found between the posterior lumbar interbody fusion procedure and the three device procedures (Coflex, Wallis, and X-stop)?
  3. What is adjacent segment degeneration and how might the three device procedures potentially lead to lower rates of it?

Doctor’s Tip

A helpful tip a doctor might tell a patient about lumbar fusion is to discuss with their surgeon the different surgical procedures available and the potential benefits and risks of each, including the use of devices such as Coflex, Wallis, and X-stop. It’s important for patients to be informed about all their options and to have open communication with their healthcare provider to make the best decision for their individual situation.

Suitable For

In general, patients who are recommended for lumbar fusion surgery are those who have not found relief from non-surgical treatments such as physical therapy, medications, or injections. Some common conditions that may warrant lumbar fusion surgery include:

  1. Degenerative disc disease: This is a condition where the discs between the vertebrae break down, causing pain and reduced mobility.

  2. Herniated disc: When the soft inner core of a disc leaks out and presses on a nerve, causing pain, numbness, or weakness in the legs.

  3. Spondylolisthesis: This is when one vertebra slips forward over the one below it, causing instability and pressure on the spinal nerves.

  4. Spinal stenosis: A narrowing of the spinal canal that puts pressure on the spinal cord and nerves, causing pain, numbness, or weakness in the legs.

  5. Fractures or instability: In cases where there is instability in the spine due to fractures or other conditions, fusion surgery may be recommended to stabilize the spine.

It is important for patients to discuss their individual condition and treatment options with their healthcare provider to determine if lumbar fusion surgery is the best course of action for them.

Timeline

Before lumbar fusion:

  1. Patient experiences chronic lower back pain and other symptoms such as leg pain or weakness.
  2. Patient undergoes various conservative treatments such as physical therapy, medications, and injections to manage symptoms.
  3. As symptoms worsen and conservative treatments are unsuccessful, the patient and their healthcare team decide on surgical intervention.
  4. Patient undergoes pre-operative evaluations and tests to ensure they are a suitable candidate for lumbar fusion surgery.

After lumbar fusion:

  1. Patient undergoes the lumbar fusion surgery, which involves removing the damaged disc and fusing the vertebrae together using bone grafts, rods, and screws.
  2. Patient stays in the hospital for a few days post-surgery for monitoring and pain management.
  3. Patient undergoes physical therapy and rehabilitation to regain strength and mobility in the back.
  4. Patient experiences a gradual improvement in symptoms over the following weeks and months.
  5. Patient continues with follow-up appointments with their healthcare team to monitor their progress and address any concerns.
  6. Patient is able to return to normal activities with reduced pain and improved function.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with lumbar fusion surgery?
  2. How long is the recovery time after lumbar fusion surgery?
  3. Will I need physical therapy after the surgery?
  4. What type of anesthesia will be used during the procedure?
  5. How long do the results of lumbar fusion surgery typically last?
  6. Will I need to make any lifestyle changes after the surgery?
  7. Are there any alternative treatments to lumbar fusion surgery that I should consider?
  8. What is the success rate of lumbar fusion surgery for patients with my specific condition?
  9. How long will I need to stay in the hospital after the surgery?
  10. Will I need to follow up with a physical therapist or other healthcare provider after the surgery?

Reference

Authors: Mo Z, Li D, Zhang R, Chang M, Yang B, Tang S. Journal: Clin Neurol Neurosurg. 2018 Sep;172:74-81. doi: 10.1016/j.clineuro.2018.06.030. Epub 2018 Jun 30. PMID: 29986199