Your browser doesn't support javascript.
loading
Clinical Utility of An Intervertebral Motion Metric for Deciding on the Addition of Instrumented Fusion in Degenerative Spondylolisthesis.
Reijmer, Joey F H; de Jong, Lex D; Kempen, Diederik H R; Arts, Mark P; van Susante, Job L C.
Afiliación
  • Reijmer JFH; Department of Orthopaedics, Rijnstate Hospital, Wagnerlaan 55, 6815 AD, Arnhem, The Netherlands.
  • de Jong LD; Department of Orthopaedics, Rijnstate Hospital, Wagnerlaan 55, 6815 AD, Arnhem, The Netherlands.
  • Kempen DHR; Joint Research, Department of Orthopaedic Surgery, OLVG, Oosterpark 9, 1090 HM, Amsterdam, The Netherlands.
  • Arts MP; Department of Neurosurgery, Haaglanden Medical Centre, Lijnbaan 32, 2512 VA, Den Haag, The Netherlands.
  • van Susante JLC; Department of Orthopaedics, Rijnstate Hospital, Wagnerlaan 55, 6815 AD, Arnhem, The Netherlands.
Spine (Phila Pa 1976) ; 2024 Jan 30.
Article en En | MEDLINE | ID: mdl-38213123
ABSTRACT
STUDY

DESIGN:

A prospective single-arm clinical study.

OBJECTIVE:

To explore the clinical utility of an intervertebral motion metric by determining the proportion of patients for whom it changed their surgical treatment plan from decompression only to decompression with fusion or vice versa. SUMMARY OF BACKGROUND DATA Lumbar spinal stenosis (LSS) from degenerative spondylolisthesis is commonly treated with decompression only or decompression with additional instrumented fusion. An objective diagnostic tool capable of establishing abnormal motion between lumbar vertebrae to guide decision-making between surgical procedures is needed. To this end a metric, based on the vertebral sagittal plane translation-per-degree-of-rotation (TPDR) calculated from flexion-extension radiographs, was developed.

METHODS:

First, spine surgeons documented their intended surgical plan. Subsequently, the participants' flexion-extension radiographs were taken. From these the TPDR was calculated and reported as a Sagittal Plane Shear Index (SPSI). The SPSI metric of the spinal level intended to treat was used to decide if the intended surgical plan needed to be changed or not.

RESULTS:

SPSI was determined for 75 participants. Of these, 51 (68%) had an intended surgical plan of decompression only and 24 (32%) decompression with fusion. In 63% of participants the SPSI was in support of their intended surgical plan. For 29% of participants the surgeon changed the surgical plan after the SPSI metric became available to them. A suggested change in surgical plan was overruled in 8% of participants. The final surgical plan was decompression only for 59 (79%) and decompression with fusion for 16 (21%) participants.

CONCLUSION:

The 29% change in intended surgical plans suggested that SPSI was considered by spine surgeons as an adjunct metric in deciding whether to perform decompression only or or to add instrumented fusion. This change exceeded the a priori defined 15% considered necessary to show potential clinical utility of SPSI.
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Prognostic_studies Idioma: En Revista: Spine (Phila Pa 1976) Año: 2024 Tipo del documento: Article País de afiliación: Países Bajos Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Prognostic_studies Idioma: En Revista: Spine (Phila Pa 1976) Año: 2024 Tipo del documento: Article País de afiliación: Países Bajos Pais de publicación: Estados Unidos