Evaluation of the Efficacy and Safety of FFX Facet Cages Compared With Pedicle Screw Fixation in Patients With Lumbar Spinal Stenosis: A Long-Term Study.

IF 1.6 4区 医学 Q3 CLINICAL NEUROLOGY
Omar Houari, Arnaud Douanla, Mehdi Ben Ammar, Mustapha Benmekhbi, Jihad Mortada, Gabriel Lungu, Cristian Magheru, Jimmy Voirin, Pablo Ariel Lebedinsky, Mariano Musacchio, Federico Bolognini, Robin Srour
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引用次数: 0

Abstract

Study design: Hybrid retrospective/prospective study.

Objective: The study evaluated the long-term safety and efficacy of the FFX facet cage versus pedicle screw (PS) fixation in patients with lumbar spinal stenosis (LSS).

Summary of background data: A previous single-arm study reported on the safety, fusion rate, and patient outcomes associated with the use of the FFX facet cage in patients with lumbar spinal stenosis. There are no long-term studies reporting outcomes with this device compared with the use of pedicle screw fixation.

Methods: Following a medical records review, subjects meeting the inclusion and exclusion criteria were consented to and enrolled in the prospective arm of the study. CT scans and dynamic X-rays were performed to assess fusion rates, range of motion, and translation. Adverse events during the 2-year post-index procedure were also analyzed. Preoperative and 2+ year Visual Analogue Scale (VAS) back and leg scores and Oswestry Disability Index (ODI) were also obtained.

Results: A total of 112 subjects were enrolled with 56 patients included in the PS and FFX groups. Mean age was 63.1±11.2 and 67.1±10.9 years and the mean number of levels operated was 1.8±0.8 and 2.3±1.0, respectively, for the PS and FFX groups. There was no difference between the 2 groups for the primary composite fusion endpoint assessed with the FFX group achieving a 91% bony facet fusion rate. There was also no difference in postoperative complications or adverse events during the 2-year follow-up period. A higher percentage of patients in the PS group (10.7%) required reoperation compared with the FFX group (3.6%). Although both groups experienced significant improvements in VAS and ODI scores versus preoperative assessment, there was no difference between the 2 groups.

Conclusion: The present study documents the long-term safety and efficacy of the FFX device in patients with LSS with a reduction in reoperation rate when compared with PS fixation.

Level of evidence: Level III.

腰椎管狭窄症患者使用 FFX 椎板面固定架与椎弓根螺钉固定术的疗效和安全性评估:一项长期研究
研究设计回顾性/前瞻性混合研究:该研究评估了腰椎管狭窄症(LSS)患者使用 FFX 椎面骨架与椎弓根螺钉(PS)固定的长期安全性和有效性:之前的一项单臂研究报告了腰椎管狭窄症患者使用 FFX 椎板骨架的安全性、融合率和患者预后。与使用椎弓根螺钉固定相比,目前还没有关于该设备疗效的长期研究报告:经过病历审查,符合纳入和排除标准的受试者同意并加入前瞻性研究。通过 CT 扫描和动态 X 光检查评估融合率、活动范围和平移。此外,还对指标术后两年内的不良事件进行了分析。此外,还获得了术前和术后2年以上的视觉模拟量表(VAS)背部和腿部评分以及Oswestry残疾指数(ODI):结果:共有 112 名受试者参加,其中 PS 组和 FFX 组共有 56 名患者。PS 组和 FFX 组的平均年龄分别为(63.1±11.2)岁和(67.1±10.9)岁,平均手术层数分别为(1.8±0.8)层和(2.3±1.0)层。两组的主要复合融合终点评估结果无差异,FFX 组的骨面融合率达到 91%。在为期两年的随访期间,两组在术后并发症或不良事件方面也没有差异。PS 组需要再次手术的患者比例(10.7%)高于 FFX 组(3.6%)。尽管与术前评估相比,两组患者的VAS和ODI评分均有明显改善,但两组之间并无差异:本研究证实了FFX装置在LSS患者中的长期安全性和有效性,与PS固定相比,FFX装置降低了再手术率:证据等级:三级。
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来源期刊
Clinical Spine Surgery
Clinical Spine Surgery Medicine-Surgery
CiteScore
3.00
自引率
5.30%
发文量
236
期刊介绍: Clinical Spine Surgery is the ideal journal for the busy practicing spine surgeon or trainee, as it is the only journal necessary to keep up to date with new clinical research and surgical techniques. Readers get to watch leaders in the field debate controversial topics in a new controversies section, and gain access to evidence-based reviews of important pathologies in the systematic reviews section. The journal features a surgical technique complete with a video, and a tips and tricks section that allows surgeons to review the important steps prior to a complex procedure. Clinical Spine Surgery provides readers with primary research studies, specifically level 1, 2 and 3 studies, ensuring that articles that may actually change a surgeon’s practice will be read and published. Each issue includes a brief article that will help a surgeon better understand the business of healthcare, as well as an article that will help a surgeon understand how to interpret increasingly complex research methodology. Clinical Spine Surgery is your single source for up-to-date, evidence-based recommendations for spine care.
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