title: Minimum 5 year follow-up of multi-segmental lumbar degenerative disease treated with discectomy and the Wallis interspinous device.
abstract: We evaluate the clinical effects and radiological findings of the Wallis interspinous device (Zimmer, Warsaw, IN, USA) for the treatment of multi-segmental lumbar degenerative disease after a minimum 5 year follow-up period. A total of 26 adult patients underwent a primary discectomy followed by fixation of the segment with the Wallis interspinous device between December 2007 and August 2008. Twelve men and 14 women with an age range of 43 to 56 years (average: 47.6) were included. The visual analogue scale (VAS) for low back and leg pain, Oswestry Disability Index (ODI), foraminal height (FH), anterior disc height (aDH) and posterior disc height (pDH), range of motion (ROM) and Pfirrmann grades were obtained and compared before and after surgery. The VAS and ODI significantly decreased postoperatively (p < 0.05). The postoperative FH and pDH values increased significantly compared with the preoperative levels (p < 0.01) and the increase in the FH and pDH values remained statistically significant during the follow-up period. There were no statistically significant changes in the aDH values before and after surgery (p > 0.05). Also, there were no statistically significant changes in the ROM and Pfirrmann grade at the instrumented level and at the cephalad-adjacent segment (p>0.05). In our study, no patient underwent further surgery because of a re-prolapse or progression of index level degeneration or adjacent segment disease. The Wallis interspinous device was a useful alternative for treating multi-segmental lumbar degenerative disease and it offered a significant minimum 5 year symptom control.
authors.affiliation: Department of Orthopaedic Surgery, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai 200032, People's Republic of China.
authors.forename: Yun-qi
authors.initials: YQ
authors.lastname: Jiang
authors.affiliation: Department of Orthopaedic Surgery, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai 200032, People's Republic of China.
authors.forename: Wu
authors.initials: W
authors.lastname: Che
authors.affiliation: Department of Orthopaedic Surgery, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai 200032, People's Republic of China.
authors.forename: Hui-ren
authors.initials: HR
authors.lastname: Wang
authors.affiliation: Department of Orthopaedic Surgery, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai 200032, People's Republic of China.
authors.forename: Ruo-yu
authors.initials: RY
authors.lastname: Li
authors.affiliation: Department of Orthopaedic Surgery, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai 200032, People's Republic of China. Electronic address: li.xilei@zs-hospital.sh.cn.
authors.forename: Xi-lei
authors.initials: XL
authors.lastname: Li
authors.affiliation: Department of Orthopaedic Surgery, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai 200032, People's Republic of China.
authors.forename: Jian
authors.initials: J
authors.lastname: Dong
mesh_terms: D000328:Adult; D004185:Disability Evaluation; D018450:Disease Progression; D017586:Diskectomy / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016268:Internal Fixators; D007403:Intervertebral Disc / Q000473:pathology / Q000601:surgery; D055959:Intervertebral Disc Degeneration / Q000000981:diagnostic imaging / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000453:epidemiology / Q000209:etiology; D011859:Radiography; D016059:Range of Motion, Articular; D012008:Recurrence; D013123:Spinal Fusion / Q000295:instrumentation; D016896:Treatment Outcome
keywords: Adjacent segment disease; Degeneration; Interspinous dynamic device; Multi-segmental; Non-fusion; Wallis