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2013년 11월 17일 일요일

The efficacy of lumbar discectomy and single-level fusion for spondylolisthesis: results from the NeuroPoint-SD registry

Brief review


*Title: The efficacy of lumbar discectomy and single-level fusion for spondylolisthesis: results from the NeuroPoint-SD registry.

*Author: Zoher Ghogawala, Christopher I. Shaffrey, Anthony L. Asher, Robert F. Heary, Tanya Logvinenko, Neil R. Malhotra, Stephen J. Dante, R. John Hurlbert, Andrea F. Douglas, Subu N. Magge, Praveen V. Mumm aneni, Joseph S. Cheng, Justin S. Smith, Michael G. Kaiser, Khalid M. Abbed, Daniel M. Sciubba, Daniel K. Resnick




Object
Purpose:
-To establish a multicenter cooperative research group.
-To demonstrate the feasibility of developing a registry to assess the efficacy of common lumbar spinal procedures.


Methods
Study type: Observational prospective cohort study (13 US academic, community sites)

Subject: Total 160 patients (lumbar disc herniation 125 + spondylolisthesis 35)
-Unselected patients undergoing lumbar discectomy or single-level fusion for spondylolisthesis.

Follow-up time: 1, 3, 6, 12 months after surgery

Evaluation method: SF-36, Oswestry Disability Index (ODI), and visual analog scale (VAS)
-pre&post


Results
-There were 198 enrolled over 1 year.
Median age: 45 yrs (49% female) for lumbar discectomy (n = 148)/
58 yrs (58% female) for lumbar spondylolisthesis (n = 50)

Complications: 12 patients (6.1%)  -At 30 days
(10 patients (6.8%) with disc herniation and 1 (2%) with spondylolisthesis)

Follow-up rate: 88.3% (over 1 yr)

Clinical outcomes(VAS, ODI, SF-36 scores): Both lumbar discectomy and single-level fusion procedures were significant improvements(p ≤ 0.0002).

Return to work: 80% of patients (for 1 yr).


-Flow diagram of the NeuroPoint-SD study showing enrollment and follow-up compliance rates.


Conclusions

-It is feasible to build a national spine registry for the collection of high-quality prospective data to demonstrate the effectiveness of spinal procedures in actual practice.