PMID- 33610854
OWN - NLM
STAT- MEDLINE
DCOM- 20220310
LR  - 20220311
IS  - 1877-0568 (Electronic)
IS  - 1877-0568 (Linking)
VI  - 107
IP  - 7
DP  - 2021 Nov
TI  - Treatment of lumbar canal stenosis in patients with compensated sagittal balance.
PG  - 102861
LID - S1877-0568(21)00073-6 [pii]
LID - 10.1016/j.otsr.2021.102861 [doi]
AB  - INTRODUCTION: The need to combine fusion with decompression in patients with 
      lumbar canal stenosis is still controversial. The aim of this study was to show 
      that isolated decompression leads to the same outcomes as decompression plus 
      fusion in patients who have preserved global sagittal balance. MATERIALS AND 
      METHODS: A single-center retrospective cohort of 110 patients who were operated 
      for a single-level lumbar stenosis was divided into two groups based on the 
      treatment: isolated decompression or fusion-decompression. These patients had a 
      normal odontoid-hip axis angle (ODHA) (-5 degrees  to +2 degrees ) and had no spondylolisthesis 
      or frontal deformity. We compared the clinical outcome scores and spinal-pelvic 
      parameters preoperatively and at 1 year of follow-up. We evaluated the minimal 
      clinically important difference (MCID) corresponding to a 12.8-point difference 
      in the Owestry Disability Index (ODI). The analysis in each group was based on 
      the MCID. RESULTS: The clinical outcome scores improved significantly in both 
      groups. There was a 77% decrease in the ODI>12.8 points with no significant 
      difference between groups. The analysis based on the MCID showed that patients 
      with a poor clinical result at 1 year in the isolated decompression group were 
      more likely to have lumbar pain, while the ones in the fusion-decompression group 
      were more likely to have radicular pain. CONCLUSION: The clinical and 
      radiological results of fusion-decompression are not superior at 1 year relative 
      to isolated decompression for treating single-level lumbar canal stenosis in 
      patients with compensated sagittal balance. Full-spine weight bearing radiographs 
      are key to determining the patient's sagittal balance and to ensuring there are 
      no radiological instability factors that may require a stabilizing procedure. 
      LEVEL OF EVIDENCE: IV Retrospective study of data collected prospectively.
CI  - Copyright (c) 2021 Elsevier Masson SAS. All rights reserved.
FAU - Mohsinaly, Yann
AU  - Mohsinaly Y
AD  - PolyClinique Bordeaux Nord Aquitaine, Bordeaux Universite, 33000 Bordeaux, 
      France.
FAU - Boissiere, Louis
AU  - Boissiere L
AD  - PolyClinique Bordeaux Nord Aquitaine, Bordeaux Universite, 33000 Bordeaux, 
      France; ELSAN Polyclinique Jean Villar, 33520 Bruges, France.
FAU - Maillot, Cedric
AU  - Maillot C
AD  - Service de chirurgie orthopedique, CHU Beaujon, 92110 Clichy, France.
FAU - Pesenti, Sebastien
AU  - Pesenti S
AD  - Service de chirurgie orthopedique pediatrique, CHU la Timone, 13000 Marseille, 
      France.
FAU - Le Huec, Jean-Charles
AU  - Le Huec JC
AD  - PolyClinique Bordeaux Nord Aquitaine, Bordeaux Universite, 33000 Bordeaux, 
      France. Electronic address: jclehuec1@gmail.com.
LA  - eng
PT  - Journal Article
DEP - 20210218
PL  - France
TA  - Orthop Traumatol Surg Res
JT  - Orthopaedics & traumatology, surgery & research : OTSR
JID - 101494830
SB  - IM
MH  - Constriction, Pathologic/etiology/surgery
MH  - Decompression, Surgical/methods
MH  - Humans
MH  - Lumbar Vertebrae/diagnostic imaging/surgery
MH  - Retrospective Studies
MH  - *Spinal Fusion/methods
MH  - *Spinal Stenosis/complications/diagnostic imaging/surgery
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Decompression
OT  - Lumbar fusion
OT  - Lumbar spinal stenosis
OT  - Odontoid-hip axis angle (ODHA)
OT  - Sagittal balance
EDAT- 2021/02/22 06:00
MHDA- 2022/03/11 06:00
CRDT- 2021/02/21 20:30
PHST- 2020/04/28 00:00 [received]
PHST- 2020/06/03 00:00 [revised]
PHST- 2020/06/04 00:00 [accepted]
PHST- 2021/02/22 06:00 [pubmed]
PHST- 2022/03/11 06:00 [medline]
PHST- 2021/02/21 20:30 [entrez]
AID - S1877-0568(21)00073-6 [pii]
AID - 10.1016/j.otsr.2021.102861 [doi]
PST - ppublish
SO  - Orthop Traumatol Surg Res. 2021 Nov;107(7):102861. doi: 
      10.1016/j.otsr.2021.102861. Epub 2021 Feb 18.