TY - JOUR
T1 - Patient Outcomes After Single-level Coflex Interspinous Implants Versus Single-level Laminectomy
AU - Zhong, Jack
AU - O'Connell, Brooke
AU - Balouch, Eaman
AU - Stickley, Carolyn
AU - Leon, Carlos
AU - O'Malley, Nicholas
AU - Protopsaltis, Themistocles S.
AU - Kim, Yong H.
AU - Maglaras, Constance
AU - Buckland, Aaron J.
N1 - Funding Information:
Paradigm Spine, New York, NY, USA funds were received in support of this work.
Publisher Copyright:
© 2021 Lippincott Williams and Wilkins. All rights reserved.
PY - 2021/7/1
Y1 - 2021/7/1
N2 - Study Design Retrospective cohort analysis. Objective The aim of this study was to compare postoperative outcomes of Coflex interspinous device versus laminectomy. Summary of Background DataCoflex Interlaminar Stabilization device (CID) is indicated for one- or two-level lumbar stenosis with grade 1 stable spondylolisthesis in adult patients, as an alternative to laminectomy, or laminectomy and fusion. CID provides stability against progressive spondylolisthesis, retains motion, and prevents further disc space collapse. Methods Patients ≥18 years' old with lumbar stenosis and grade 1 stable spondylolisthesis who underwent either primary single-level decompression and implantation of CID, or single-level laminectomy alone were included with a minimum 90-day follow-up at a single academic institution. Clinical characteristics, perioperative outcomes, and postoperative complications were reviewed until the latest follow-up. χ2and independent samples t tests were used for analysis. Results Eighty-three patients (2007-2019) were included: 37 cases of single-level laminectomy (48.6% female) were compared to 46 single-level CID (50% female). CID cohort was older (CID 69.0±9.4 vs. laminectomy 64.2±11.0, P=0.042) and had higher American Society of Anesthesiologists (ASA) grade (CID 2.59±0.73 vs. laminectomy 2.17±0.48, P=0.020). CID patients had higher estimated blood loss (EBL) (97.50±77.76 vs. 52.84±50.63mL, P=0.004), longer operative time (141.91±47.88 vs. 106.81±41.30minutes, P=0.001), and longer length of stay (2.0±1.5 vs. 1.1±1.0days, P=0.001). Total perioperative complications (21.7% vs. 5.4%, P=0.035) and instrumentation-related complication was higher in CID (10.9% vs. 0% laminectomy group, P=0.039). There were no other significant differences between the groups in demographics or outcomes. Conclusion Single-level CID devices had higher perioperative 90-day complications, longer operative time, length of stay, higher EBL compared to laminectomies alone. Similar overall revision and neurologic complication rates were noted compared to laminectomy at last follow-up. Level of Evidence: 3.
AB - Study Design Retrospective cohort analysis. Objective The aim of this study was to compare postoperative outcomes of Coflex interspinous device versus laminectomy. Summary of Background DataCoflex Interlaminar Stabilization device (CID) is indicated for one- or two-level lumbar stenosis with grade 1 stable spondylolisthesis in adult patients, as an alternative to laminectomy, or laminectomy and fusion. CID provides stability against progressive spondylolisthesis, retains motion, and prevents further disc space collapse. Methods Patients ≥18 years' old with lumbar stenosis and grade 1 stable spondylolisthesis who underwent either primary single-level decompression and implantation of CID, or single-level laminectomy alone were included with a minimum 90-day follow-up at a single academic institution. Clinical characteristics, perioperative outcomes, and postoperative complications were reviewed until the latest follow-up. χ2and independent samples t tests were used for analysis. Results Eighty-three patients (2007-2019) were included: 37 cases of single-level laminectomy (48.6% female) were compared to 46 single-level CID (50% female). CID cohort was older (CID 69.0±9.4 vs. laminectomy 64.2±11.0, P=0.042) and had higher American Society of Anesthesiologists (ASA) grade (CID 2.59±0.73 vs. laminectomy 2.17±0.48, P=0.020). CID patients had higher estimated blood loss (EBL) (97.50±77.76 vs. 52.84±50.63mL, P=0.004), longer operative time (141.91±47.88 vs. 106.81±41.30minutes, P=0.001), and longer length of stay (2.0±1.5 vs. 1.1±1.0days, P=0.001). Total perioperative complications (21.7% vs. 5.4%, P=0.035) and instrumentation-related complication was higher in CID (10.9% vs. 0% laminectomy group, P=0.039). There were no other significant differences between the groups in demographics or outcomes. Conclusion Single-level CID devices had higher perioperative 90-day complications, longer operative time, length of stay, higher EBL compared to laminectomies alone. Similar overall revision and neurologic complication rates were noted compared to laminectomy at last follow-up. Level of Evidence: 3.
KW - Coflex
KW - interlaminar device
KW - laminectomy
KW - lumbar stenosis
KW - outcomes
KW - spondylolisthesis
UR - https://www.scopus.com/pages/publications/85108023417
U2 - 10.1097/BRS.0000000000003924
DO - 10.1097/BRS.0000000000003924
M3 - Article
C2 - 33395022
AN - SCOPUS:85108023417
SN - 0362-2436
VL - 46
SP - 893
EP - 900
JO - Spine
JF - Spine
IS - 13
ER -