title: The Likelihood of Reaching Substantial Clinical Benefit After an Interlaminar Dynamic Spacer for Chronic Low Back Pain: A Clinical and Radiologic Analysis of a Prospective Cohort.
abstract: OBJECTIVE
  Chronic low back pain (CLBP) often causes disabling pain that impairs a patient's quality of life. Surgical treatment is recommended for patients who do not respond to conservative treatments lasting more than 6 months. The purpose of this study is to present results after the use of an interlaminar dynamic spacer for CLBP.
  
  
  METHODS
  We enrolled consecutive patients with CLBP irresponsive to more than 6 months of conservative treatment into the present study. Included patients underwent an interlaminar dynamic spacer insertion without direct decompression. We assessed radiographic parameters and health-related quality of life (HRQoL) data included visual analog scale back/leg pain and Oswestry Disability Index scores. Substantial clinical benefit achievement was assessed.
  
  
  RESULTS
  Thirty-five patients (average age, 47.8 years; 21 female) were included. The mean preoperative symptom duration was 29.6 months. Surgeries involved 1-level (n = 18) and 2-levels (n = 17) procedures. Operative levels included L4-5 (n = 8), L5-S1 (n = 10), L3-4-5 (n-2), and L4-5-S1 (n = 15). The average follow-up period was 16.6 months. After the procedure, all radiographic parameters (including disc height, segmental extension angle, and foraminal area) improved significantly. All preoperative HRQoL parameters improved significantly at the final follow-up. Substantial clinical benefit achievement was observed in 75.8% of the cases on the Oswestry Disability Index, and in 72.7% and 84.8% of the cases on the visual analog scale back and leg pain, respectively.
  
  
  CONCLUSIONS
  An interlaminar dynamic spacer significantly improves HRQoL scores in patients with CLBP who do not respond to conservative treatment. Although encouraging, these results should be confirmed with studies assessing a larger cohort and a longer follow-up.
authors.affiliation: Department of Neurosurgery, Spine Health Wooridul Hospital, Seoul, South Korea. Electronic address: jsbaemd@gmail.com.
authors.forename: Junseok
authors.initials: J
authors.lastname: Bae
authors.affiliation: Department of Neurosurgery, Spine Health Wooridul Hospital, Seoul, South Korea.
authors.forename: Shih Min
authors.initials: SM
authors.lastname: Lee
authors.affiliation: Department of Neurosurgery, Spine Health Wooridul Hospital, Seoul, South Korea.
authors.forename: Sang-Ho
authors.initials: SH
authors.lastname: Lee
authors.affiliation: Department of Neurosurgery, Spine Health Wooridul Hospital, Seoul, South Korea.
authors.forename: Sang-Ha
authors.initials: SH
authors.lastname: Shin
authors.affiliation: Department of Neurosurgery, Spine Health Wooridul Hospital, Seoul, South Korea.
authors.forename: Ho-Jin
authors.initials: HJ
authors.lastname: Kim
authors.affiliation: Department of Orthopedic Surgery, Spine Health Wooridul Hospital, Seoul, South Korea.
authors.forename: Kyeong Hwan
authors.initials: KH
authors.lastname: Kim
mesh_terms: D000328:Adult; D059350:Chronic Pain / Q000000981:diagnostic imaging* / Q000601:surgery*; D015331:Cohort Studies; D019299:Decompression, Surgical / Q000295:instrumentation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017116:Low Back Pain / Q000000981:diagnostic imaging* / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery; D008297:Male; D008875:Middle Aged; D059408:Pain Management / Q000295:instrumentation / Q000379:methods*; D017060:Patient Satisfaction; D011446:Prospective Studies; D012447:Sacrum / Q000000981:diagnostic imaging / Q000601:surgery; D016896:Treatment Outcome
keywords: Chronic low back pain; Degenerative disc disease; Interlaminar device; Interlaminar dynamic spacer; Motion preservation