Posterior Lateral Arthrodesis as a Treatment Option for Lumbar Spinal Stenosis: Safety and Early Clinical Outcomes

Anuj Shah; Jonathan M Hagedorn; Usman Latif; Ashley Bailey-Classen; Nomen Azeem; Douglas P Beall; Pankaj Mehta; Chad Stephens; Larry Khoo; Timothy Ray Deer

doi:10.2147/JPR.S422736

Posterior Lateral Arthrodesis as a Treatment Option for Lumbar Spinal Stenosis: Safety and Early Clinical Outcomes

J Pain Res. 2024 Jan 5:17:107-116. doi: 10.2147/JPR.S422736. eCollection 2024.

Authors

Affiliations

¹ Department of Physical Medicine and Rehabilitation, Detroit Medical Center, Detroit, MI, USA.
² Department of Anesthesiology and Perioperative Medicine, Division of Pain Medicine, Mayo Clinic, Rochester, MN, USA.
³ Department of Anesthesiology and Pain Medicine, University of Kansas Health System, Kansas City, KS, USA.
⁴ Trinity Pain Medicine Associates, Fort Worth, TX, USA.
⁵ Florida Spine & Pain Specialists, Riverview, FL, USA.
⁶ Comprehensive Specialty Care, Edmond, OK, USA.
⁷ Pain Specialists of Austin and Central Texas Pain Center, Austin, TX, USA.
⁸ Noble Pain Management and Sports Medicine, Southlake, TX, USA.
⁹ The Spine Clinic of Los Angeles, Los Angeles, CA, USA.
¹⁰ The Spine and Nerve Center of the Virginias, Charleston, WV, USA.

Abstract

Introduction: Lumbar spinal stenosis (LSS) is a common condition caused by degenerative changes in the lumbar spine with age. LSS is caused by a variety of factors, including degenerative spondylosis and spondylolisthesis. People suffering with LSS experience neurogenic claudication, which causes severe physical limitations, discomfort, and a decrease in quality of life. Less invasive procedures are now being researched to improve the prognosis, success rate, and safety of LSS treatments. Posterior lateral spinal arthrodesis (PLSA) is a new surgical treatment for LSS. This study looks at the procedural and patient safety of PLSA.

Materials and methods: This study is a multicenter retrospective analysis of the safety of PLSA who met the clinical indications for PLSA and underwent the procedure at eight interventional spine practices. Data was collected on demographical information, pre-procedural numeric rating scale score (NRS), post-procedural NRS, and complication reporting. Patients who were included had LSS with or without spondylolisthesis and had failed conservative treatments. A descriptive statistical analysis was performed to report the outcomes. Results were reported as mean and standard deviations for continuous outcomes, and frequency (%) for categorical outcomes.

Results: This retrospective analysis involved 191 patients and 202 PLSA implants. The majority of patients were male Caucasians with a mean age of 69.2 years and a BMI of 31.1. A large majority of implants were placed at the L4-5 level, and the average pre-procedural NRS was 6.3 while the average post-procedural NRS was 3.1, indicating a 50.8% reduction in pain (p < 0.0001). Two patients reported complications, but they were unrelated to the device or surgical procedure; no infections, device malfunctions, or migrations were reported in the patient cohort.

Conclusion: Preliminary results with PLSA implants indicate that it is a safe treatment option for patients with moderate LSS who do not respond to conservative management.

Keywords: Minuteman; interspinous fusion; lumbar spinal stenosis; posterior lateral spinal arthrodesis; spinal simplicity; spondylolisthesis.