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Adjacent segmental degeneration following Wallis interspinous stabilization implantation: Biomechanical explanations and the value of magnetic resonance imaging.

Abstract Adjacent segmental degeneration (ASD) is a major issue after pedicular fixation. This study examined the degeneration of the adjacent levels due to the insertion of the Wallis interspinous stabilization system compared with discectomy, using magnetic resonance imaging (MRI).Thirty-eight patients diagnosed with lumbar degeneration disorders at L4-L5 were reviewed: 19 patients underwent discectomy and Wallis system implantation (group A), and 19 patients underwent discectomy (group B). The Visual Analog Scale (VAS) and Oswestry Disability Index (ODI) were assessed preoperatively and postoperatively. ASD was evaluated by MRI.There was no difference in the preoperative ODI scores between the 2 groups (non-normal distribution, median, 50 (40, 50) vs 50 (50, 50), P = .331), but the postoperative ODI scores were different (non-normal distribution, median, 0 (0, 32) vs 20 (20, 30), P < .005). Similar results were observed for VAS. In group A, ASD occurred in 4 patients (21.1%) in the disc and 8 (42.1%) in the facet joint at L3/4, and in 4 (21.1%) in the disc and 5 (26.3%) in the facet joint at L5/S1. In Group B, ASD occurred in 3 patients (15.8%) in the disc at L3/4, and in 4 (21.1%) in the disc at L5/S1. In general, there was no difference between the 2 groups (P > .05), except at L3/4 (P = .015).ASD of the facet joint in the cranial segment occurred after Wallis system implantation, suggesting that the Wallis system cannot prevent ASD of the facet joint, but could have some other benefits for the discs.
PMID
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Authors

Mayor MeshTerms

Internal Fixators

Magnetic Resonance Imaging

Keywords
Journal Title medicine
Publication Year Start




PMID- 28562570
OWN - NLM
STAT- MEDLINE
DA  - 20170531
DCOM- 20170630
LR  - 20170630
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 96
IP  - 22
DP  - 2017 Jun
TI  - Adjacent segmental degeneration following Wallis interspinous stabilization
      implantation: Biomechanical explanations and the value of magnetic resonance
      imaging.
PG  - e7056
LID - 10.1097/MD.0000000000007056 [doi]
AB  - Adjacent segmental degeneration (ASD) is a major issue after pedicular fixation. 
      This study examined the degeneration of the adjacent levels due to the insertion 
      of the Wallis interspinous stabilization system compared with discectomy, using
      magnetic resonance imaging (MRI).Thirty-eight patients diagnosed with lumbar
      degeneration disorders at L4-L5 were reviewed: 19 patients underwent discectomy
      and Wallis system implantation (group A), and 19 patients underwent discectomy
      (group B). The Visual Analog Scale (VAS) and Oswestry Disability Index (ODI) were
      assessed preoperatively and postoperatively. ASD was evaluated by MRI.There was
      no difference in the preoperative ODI scores between the 2 groups (non-normal
      distribution, median, 50 (40, 50) vs 50 (50, 50), P = .331), but the
      postoperative ODI scores were different (non-normal distribution, median, 0 (0,
      32) vs 20 (20, 30), P &lt; .005). Similar results were observed for VAS. In group A,
      ASD occurred in 4 patients (21.1%) in the disc and 8 (42.1%) in the facet joint
      at L3/4, and in 4 (21.1%) in the disc and 5 (26.3%) in the facet joint at L5/S1. 
      In Group B, ASD occurred in 3 patients (15.8%) in the disc at L3/4, and in 4
      (21.1%) in the disc at L5/S1. In general, there was no difference between the 2
      groups (P &gt; .05), except at L3/4 (P = .015).ASD of the facet joint in the cranial
      segment occurred after Wallis system implantation, suggesting that the Wallis
      system cannot prevent ASD of the facet joint, but could have some other benefits 
      for the discs.
FAU - Zhou, Zhiguo
AU  - Zhou Z
AD  - aDepartment of Orthopaedics, Wuhan Children's Hospital (Wuhan Maternal and Child 
      Healthcare Hospital), Tongji Medical College, Huazhong University of Science and 
      Technology, Wuhan bDepartment of Orthopaedics cDepartment of Radiology, Tongji
      Hospital, Tongji Medical College, Huazhong University of Science and Technology, 
      Wuhan, China.
FAU - Xiong, Wei
AU  - Xiong W
FAU - Li, Li
AU  - Li L
FAU - Li, Feng
AU  - Li F
LA  - eng
PT  - Journal Article
PT  - Observational Study
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
SB  - AIM
SB  - IM
MH  - Biomechanical Phenomena
MH  - Disability Evaluation
MH  - Diskectomy/adverse effects
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - *Internal Fixators/adverse effects
MH  - Intervertebral Disc Degeneration/*diagnostic imaging/physiopathology/*surgery
MH  - Lumbar Vertebrae/*diagnostic imaging/*surgery
MH  - *Magnetic Resonance Imaging
MH  - Male
MH  - Middle Aged
MH  - Pain Measurement
MH  - Pain, Postoperative
MH  - Retrospective Studies
MH  - Treatment Outcome
PMC - PMC5459735
EDAT- 2017/06/01 06:00
MHDA- 2017/07/01 06:00
CRDT- 2017/06/01 06:00
AID - 10.1097/MD.0000000000007056 [doi]
AID - 00005792-201706020-00046 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2017 Jun;96(22):e7056. doi: 10.1097/MD.0000000000007056.