Document Type

Conference Proceeding - Restricted Access

Publication Date

9-2022

Publication Title

Spine Journal

Abstract

BACKGROUND CONTEXT

Degenerative spondylolisthesis (DS) with lumbar spinal stenosis (LSS) is commonly treated with decompression and fusion. The LimiFlex Dynamic Sagittal Tether (DST) is an investigational stabilization device for patients with DS and LSS.

PURPOSE

Assess return to work (RTW) and activities of daily living (ADL) receiving either decompression and DST stabilization (D+DST) or decompression and transforaminal lumbar interbody fusion (D+TLIF).

STUDY DESIGN/SETTING

Interim analysis from a multicenter, concurrently controlled study.

PATIENT SAMPLE

Patients undergoing treatment (D+DST or D+TLIF) of Grade I Meyerding lumbar DS. Propensity score (PS) selected patients with 12-month follow-up were included.

OUTCOME MEASURES

Time to RTW and activities of daily living, as well as Oswestry disability index (ODI).

METHODS

PS-selected IDE study subjects with 12 months of follow-up were included in this analysis. Study records queried for work status preoperatively and at 12 months, as well as time to RTW and ADL, and change in disability (Oswestry Disability Index; ODI) at 12 months vs preop. Outcomes were compared using student's t-tests.

RESULTS

PS-selected subjects totaled 267 (136 D+DST, 131 D+TLIF). Preoperatively, 49% of D+DST and 43% of D+TLIF subjects were working (p=0.14) and 7% D+DST and 11% D+TLIF were not working due to spinal condition (NWSC) (p=0.13). At 12 months postop, 44% of D+DST and 34% of D+TLIF subjects were working (p=0.05) and 2% D+DST and 10% D+TLIF were NWSC (pCONCLUSIONS The primary objective of surgery for symptomatic DS is resolution of symptoms so patients can return to their normal ADL and work. Both D+DST and D+TLIF treated patients demonstrated a significant reduction in disability at 12-month follow-up. Significantly faster RTW and ADL were observed for D+DST compared to D+TLIF patients, by an average of more than 5 weeks. The proportion of D+DST patients NWSC was significantly less than at 12 months. Results indicate a significant advantage of earlier recovery for the D+DST patients allowing earlier RTW and earlier increase in ADLs compared to D+TLIF, with similar or greater improvements in disability after one year for patients treated with decompression and stabilization for symptomatic DS. Longer-term follow-up assessment with propensity score-adjusted outcomes will demonstrate whether this advantage and long-term outcomes are durable and generalizable.

Volume

22

Issue

9 Suppl

First Page

S12

Comments

North American Spine Society 37th Annual Meeting, October 12-15, 2022, Chicago, IL.

Annual Scientific Meeting of the American Association of Neurological Surgeons, April 29- May 2, 2022, Philadelphia, PA.

Villavicencio A, Burneikiene S, Sasso R, Hu S, Yoon T, Lavelle W, et al. [Perez-Cruet M, Fischgrund J]. Return to work, activities of daily living and disability improvement: 12-month outcomes of an FDA IDE trial of decompression and tension band stabilization for degenerative spondylolisthesis. J Neurosurg. 2022 May;136(5). doi:10.3171/2022.5.JNS.AANS2022abstracts.

DOI

10.1016/j.spinee.2022.06.038

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