Clinical Efficacy of Spinal Instrumentation in Lumbar Degenerative Disc Disease

Zucherman, James; Hsu, Ken-Yuh; Picetti, George D.; White, Arthur H.; Wynne, Garnet F.; Taylor, Lloyd W.

doi:10.1097/00007632-199207000-00018

Cited by 51 publications

(21 citation statements)

References 3 publications

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“…The advantage of supplementary pedicle screw fixation is to provide instant stability to obtain better fusion rates. [9][10][11][18][19][20][21] In their prospective randomized studies, Zdeblick 5 and Carragee et al 9 showed better fusion rates of PLF with pedicle screw fixation in isthmic spondylolisthesis. However, Mo¨ller et al 7 and Christensen et al 22 showed that supplementary pedicle screw fixation to PLF did not affect fusion rate nor functional outcomes.…”

Section: Role Of the Pssmentioning

confidence: 97%

Radiological Risk Factors of Pseudoarthrosis and/or Instrument Breakage After PLF With the Pedicle Screw System in Isthmic Spondylolisthesis

Suda

Ito²,

Abumi³

et al. 2006

Journal of Spinal Disorders &Amp; Techniques

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Section: Role Of the Pssmentioning

confidence: 97%

Radiological Risk Factors of Pseudoarthrosis and/or Instrument Breakage After PLF With the Pedicle Screw System in Isthmic Spondylolisthesis

Suda

Ito²,

Abumi³

et al. 2006

Journal of Spinal Disorders &Amp; Techniques

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“…However, satisfactory fusion and pain outcomes do not correlate in all series, 10 and even when outcome is satisfactory, return to premorbid employment is not assured. 15,35,40,42 Correlation of good clinical outcome to successful arthrodesis in pseudoarthrosis repair is reported in some series 24,40,47 and appears unreliable in others. 26,38 Finally, despite increased fusion rates with the addition of pedicle screw fixation, evidence suggests that factors other than solid fusion markedly influence clinical outcome in patients undergoing operation for degenerative disc disease.…”

Section: Correlation Of Fusion and Outcomementioning

confidence: 99%

Outcome analysis for adults with spondylolisthesis treated with posterolateral fusion and transpedicular screw fixation

Schnee¹,

Freese²,

Ansell³

1997

Journal of Neurosurgery

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The outcomes of 52 adult patients with symptomatic low-grade spondylolisthesis treated with autologous posterolateral arthrodesis and pedicle screw fixation were retrospectively reviewed. Although a 90% rate of successful fusion was obtained using this technique, only 60% of patients were considered to have good outcomes. Treatment failures consisted mostly of back pain and were not predicted by preoperative symptoms. Compensation claims and smoking had very significant adverse impacts on both employment and pain results despite high fusion rates, particularly in patients under the age of 55 years. Overall, patients who required more than one operation demonstrated poor outcomes compared to those who only needed one. However, patients with at least two prior operations or preoperative pseudoarthrosis fared particularly poorly, whereas those who had undergone only one prior surgery and had no attendant compensation issue reported good results. A trend toward poor outcome was observed in patients with postlaminectomy spondylolisthesis, versus those with isthmic or degenerative etiologies. Gender did not exert an impact on outcome. The authors conclude that autologous posterolateral arthrodesis combined with pedicle screw fixation resulted in a high fusion rate, and contributed to successful outcomes in the treatment of certain subgroups of adults with spondylolisthesis. In the absence of other risk factors, patients may obtain significant benefit from surgery despite older age and a single failed operation. Careful patient selection appears critical in predicting the maximum benefit from this technique.

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“…Among the most commonly cited indication is the treatment of symptoms associated with degenerative diseases of the spine. [1][2][3][4][5][6][7] These include various subdiagnoses along the degenerative cascade, such as discogenic back pain, degenerative spondylolisthesis, herniated discs, and degenerative scoliosis. As part of the cascade, they share a common underlying process that can result in distinct pathologic features.…”

mentioning

confidence: 99%

The Influence of Subdiagnosis on Radiographic and Clinical Outcomes After Lumbar Fusion for Degenerative Disc Disorders: An Analysis of the Literature From Two Decades

Bono¹,

Lee²

2005

Spine

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The present data indicate that clinical outcomes and fusion rates statistically differ among the various subgroups of degenerative disc disease. Concerning the use of instrumentation, it appears that it may have greater clinical benefit in patients with DDDsp than DDDn. These findings underscore the importance of delineating specific clinical diagnoses when documenting results of lumbar fusion. This information might also be useful for both selecting surgical candidates and discussing anticipated operative outcomes.

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Clinical Efficacy of Spinal Instrumentation in Lumbar Degenerative Disc Disease

Cited by 51 publications

References 3 publications

Radiological Risk Factors of Pseudoarthrosis and/or Instrument Breakage After PLF With the Pedicle Screw System in Isthmic Spondylolisthesis

Radiological Risk Factors of Pseudoarthrosis and/or Instrument Breakage After PLF With the Pedicle Screw System in Isthmic Spondylolisthesis

Outcome analysis for adults with spondylolisthesis treated with posterolateral fusion and transpedicular screw fixation

The Influence of Subdiagnosis on Radiographic and Clinical Outcomes After Lumbar Fusion for Degenerative Disc Disorders: An Analysis of the Literature From Two Decades

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