Hybrid Procedure: Clinical Results in 93 Patients

[iSpine-Admin]

Simultaneous LumbarArthroplasty and Arthrodesis – The Hybrid Procedure: Clinical Results in 93 Patients

(from http://www.cns.org/spine/2007/pdf/2007DigitalPoster.pdf)

Matthew Scott-Young, FRACS, MBBS,
Carly Magno, BSC,
David Nielsen, BSC

Introduction: Multi-level lumbar arthroplasty may be contraindicated in patients with multi-level degenerative disease. In these patients, simultaneous arthroplasty and arthrodesis (a hybrid procedure) may provide the benefits of motion-sparing technology, without necessitating fusion
of all of the affected levels.

Methods: A total of 93 patients withmulti-level lumbar degenerative disease underwent a hybrid arthoplasty/arthrodesis procedure. In this series, 58 had lumbar arthroplasty at one-level and simultaneous lumbar arthrodesis at a second level; 31 had two-level arthroplasty adjacent to an arthrodesis, and 4 had one-level arthroplasty adjacent to a two-level arthrodesis. Clinical data were collected prospectively prior to surgery and at 3, 6, 12, and 24 months postoperatively. Clinical outcomes were measured using ODI, VAS (back and leg), Roland-Morris, and SF-36 questionnaires.

Results: Mean follow-up was 10.6 months(3-32 months). Results at latest follow-up vs. baseline were: mean ODI reduced to 18.2 from 47.5
(-62%); mean back VAS reduced to 1.9 from 7.5 (-75%); mean leg VAS reduced to 1.6 from 5.8 (-72%); mean RM reduced to 4.8 from 16.6 (-71%); mean SF-36 PCS increased to 45.4 from 28.5 (+59%), mean SF-36 MCS increased to 51.9 from 40.5 (+28%). There were no revisions at either the
index levels or any adjacent levels.

Conclusion: This is the largest series ofhybrid lumbar arthroplasty/arthrodesis cases reported to date. Though the follow-up in this series is limited, the clinical outcomes are excellent in patients with multi-level disease and symptomology. Further study of hybrid procedures for
multi-level lumbar degenerative disease from other investigators is recommended to confirm these results.