Wallis Interspinous Spacer for Treatment of Primary Lumbar Disc Herniation: Three-Year Results of a Randomized Controlled Trial

Gu, Hongtao; Chang, Yunbing; Zeng, Shixing; Zheng, Xiaoqing; Zhang, Ruiying; Zhan, Siyan; Zhang, Zhongmin

doi:10.1016/j.wneu.2018.09.086

Cited by 14 publications

(11 citation statements)

References 17 publications

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“…Two comparative analyses in patients with disc herniation in which a Wallis was added with follow-up between 3 and 4 years should be highlighted. 20,21 These studies coincide in their conclusions, finding no statistically significant differences in the final result between the 2 groups. In degenerative discopathy as a pathological entity, Buric et al 22 implanted a DIAM in a total of 52 patients, reporting improvement in VAS in 67% and in functionality in 79% after a 4-year follow-up.…”

Section: Discussionsupporting

confidence: 71%

Analysis of Long-Term Results of Lumbar Discectomy With and Without an Interspinous Device

et al. 2022

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Background: Discectomy is the surgical treatment of choice for disc herniation. However, discectomy can lead to disc degeneration and vertebral instability over time. Interspinous devices (ISDs), added to conventional surgery, constitute a lowinvasive alternative that attempts to prevent these complications. The aim of this study is to compare the long-term clinical and functional outcomes of patients undergoing conventional discectomy with those who had an ISD added during surgery.Methods: This analytical-descriptive, retrospective, and transversal studyinvestigated outcomes of 114 patients who underwent surgery for a lumbar disc herniation between 2008 and 2011. The results were evaluated with a minimum follow-up of 8 years (mean, 10 years) by means of different questionnaires: visual analog scale (VAS), Oswestry Disability Index (ODI), consumption of analgesic medication, work status, degree of satisfaction, and complications and reinterventions during the follow-up period.Results: At the end of the follow-up, an overall improvement of VAS of 5 points (71%) and ODI of 36 points (77%) was observed, with a degree of satisfaction of 76% with disc surgery. The analysis between both groups showed a better behavior in VAS and ODI in the implant group, with a pre-and postsurgery difference of 73% and 79% compared to 66% and 77% in the control group, respectively, though this finding was not statistically significant. The current analgesic consumption and the degree of satisfaction were also better in the group with an implant. Compared with the non-implant group, the number of reinterventions at the end of the follow-up was lower (7% vs 15.5%) and the time until the second intervention was higher (81.5 vs 41 months) in the group with an implant, but the differences were not statistically significant.Conclusions: Lumbar discectomy proved to be a safe technique for the treatment of disc herniation, and results are maintained over time. The additional gesture of adding an ISD to conventional discectomy improves clinical outcomes overall, but not in a statistically significant way. The lower number of reinterventions and the longer period without surgery being required may mean a certain protective effect of the ISD on the intervertebral disc being operated on.

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Section: Discussionsupporting

confidence: 71%

Analysis of Long-Term Results of Lumbar Discectomy With and Without an Interspinous Device

et al. 2022

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“…Traditionally, the interlaminar devices and interspinous process devices are frequently categorized together [ 8 , 21 , 22 ]. Most previous studies have focused only on comparing interlaminar or interspinous device to other lumbar surgical techniques [ 9 , 10 , 12 , 15 , 23 ], and few studies have focused on assessing whether the position of such device placement has an influence on biomechanical or clinical outcomes. In order to assess whether there is a fundamental difference in the biomechanical performance of the interlaminar device and interspinous process device, we comprehensively compared the biomechanical characteristics of DA, DF, decompression with interlaminar stabilization (ILS), and decompression with interspinous stabilization (ISS) by using the finite element (FE) methods.…”

Section: Introductionmentioning

confidence: 99%

Interlaminar stabilization offers greater biomechanical advantage compared to interspinous stabilization after lumbar decompression: a finite element analysis

Teng

2020

J Orthop Surg Res

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Background Interlaminar stabilization and interspinous stabilization are two newer minimally invasive methods for lumbar spine stabilization, used frequently in conjunction with lumbar decompression to treat lumbar stenosis. The two methods share certain similarities, therefore, frequently being categorized together. However, the two methods offer distinct biomechanical properties, which affect their respective effectiveness and surgical success. Objective To compare the biomechanical characteristics of interlaminar stabilization after lumbar decompression (ILS) and interspinous stabilization after lumbar decompression (ISS). For comparison, lumbar decompression alone (DA) and decompression with instrumented fusion (DF) were also included in the biomechanical analysis. Methods Four finite element models were constructed, i.e., DA, DF, ISS, and ILS. To minimize device influence and focus on the biomechanical properties of different methods, Coflex device as a model system was placed at different position for the comparison of ISS and ILS. The range of motion (ROM) and disc stress peak at the surgical and adjacent levels were compared among the four surgical constructs. The stress peak of the spinous process, whole device, and device wing was compared between ISS and ILS. Results Compared with DA, the ROM and disc stress at the surgical level in ILS or ISS were much lower in extension. The ROM and disc stress at the surgical level in ILS were 1.27° and 0.36 MPa, respectively, and in ISS 1.51°and 0.55 MPa, respectively in extension. This is compared with 4.71° and 1.44 MPa, respectively in DA. ILS (2.06–4.85° and 0.37–0.98 MPa, respectively) or ISS (2.07–4.78° and 0.37–0.98 MPa, respectively) also induced much lower ROM and disc stress at the adjacent levels compared with DF (2.50–7.20° and 0.37–1.20 MPa, respectively). ILS further reduced the ROM and disc stress at the surgical level by 8% and 25%, respectively, compared to ISS. The stress peak of the spinous process in ILS was significantly lower than that in ISS (13.93–101 MPa vs. 31.08–172.5 MPa). In rotation, ILS yielded a much lower stress peak in the instrumentation wing than ISS (128.7 MPa vs. 222.1 MPa). Conclusion ILS and ISS partly address the issues of segmental instability in DA and hypermobility and overload at the adjacent levels in DF. ILS achieves greater segmental stability and results in a lower disc stress, compared to ISS. In addition, ILS reduces the risk of spinous process fracture and device failure.

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“…Efficacy in other indications, like prevention of adjacent segment disease or recurrent disk herniation, is unclear. 40…”

Section: Discussionmentioning

confidence: 99%

Clinical Practice in Spine Surgery: An International Survey

Pérez-Bovet

Buxó

Muñoz

2021

J Neurol Surg A Cent Eur Neurosurg

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Background The availability of diverse and sophisticated surgical options to treat spine conditions is compounded by the scarcity of high-level evidence to guide decision-making. Although studies on discrete treatments are frequently published, little information is available regarding real-world surgical practice. We intended to survey spine surgeons to assess clinical management of common spine diagnosis in day-to-day settings. Methods An online survey was distributed among neurosurgeons and orthopaedic surgeons worldwide. The obtained assessment of common surgical practice is contextualized in a review of the best available evidence. Results The survey was answered by more than 310 members of several European, Australasian, and South African professional societies. The submitted responses translate a surgical practice generally grounded on evidence, favoring well-tried techniques, providing comprehensive treatment for the most severe diagnoses. Such practice comes mostly from neurosurgeons focused on spine surgery, practicing in teaching hospitals. Conclusion We believe that the pragmatic, day-to-day approach to spine conditions captured in the present survey offers an informative insight to involved surgeons.

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Wallis Interspinous Spacer for Treatment of Primary Lumbar Disc Herniation: Three-Year Results of a Randomized Controlled Trial

Cited by 14 publications

References 17 publications

Analysis of Long-Term Results of Lumbar Discectomy With and Without an Interspinous Device

Analysis of Long-Term Results of Lumbar Discectomy With and Without an Interspinous Device

Interlaminar stabilization offers greater biomechanical advantage compared to interspinous stabilization after lumbar decompression: a finite element analysis

Clinical Practice in Spine Surgery: An International Survey

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