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Wallis interspinous device versus discectomy for lumbar disc herniation

A comparative study

Interspinöses Wallis-Implantat vs. Diskektomie bei lumbalem Bandscheibenvorfall

Eine Vergleichsstudie

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Abstract

The aim of this study was to assess the efficacy of the Wallis interspinous device for treating lumbar disc herniation (LDH) as well as to investigate whether the device could reduce the incidence of recurrent herniation in comparison with disc excision alone. A total of 72 patients with LDH were treated with primary discectomy and the Wallis interspinous device was implanted in 36. Clinical outcomes were evaluated with a visual analog scale (VAS) for low back and leg pain and the Oswestry Disability Index (ODI) before and after surgery. The incidence of recurrent disc herniation after the operation was also evaluated. There was a significant improvement (p < 0.01) in the clinical outcomes assessed by the VAS and ODI scores compared with preoperative values in both groups. Up to the final follow-up, there were no significant differences between the two groups in VAS and ODI scores (p > 0.05). In addition, there was no significant difference regarding the incidence of recurrent disc herniation between the two groups (13.9% vs. 16.6%, p > 0.05). Of the patients five underwent second discectomy or fusion surgery. The Wallis interspinous device was unable to improve the already good clinical outcome after discectomy for LDH and prevent or reduce recurrence of herniated disc in the current follow-up interval. Whether the device for should be used for LDH should be carefully considered before surgery.

Zusammenfassung

Ziel der vorliegenden Studie war, die Wirksamkeit des interspinösen Wallis-Implantats bei lumbalem Bandscheibenvorfall (LBSV) zu bestimmen und zu prüfen, ob das Device die Inzidenz rezidivierender Bandscheibenvorfälle gegenüber der alleinigen Diskektomie senken kann. Insgesamt 72 Patienten mit LBSV wurden einer primären Diskektomie unterzogen, bei 36 wurde das interspinöse Wallis-Device implantiert. Klinische Ergebnisse wurden mit einer visuellen Analogskala (VAS) für Schmerzen am unteren Rücken und Bein sowie mit dem Oswestry Disability Index (ODI) vor und nach dem operativen Eingriff beurteilt. Die Inzidenz rezidivierender Bandscheibenvorfälle nach Operation wurde ebenfalls bestimmt. Bezüglich der klinischen Ergebnisse, die mit VAS- und ODI-Scores beurteilt wurden, fand sich in beiden Gruppen eine signifikante Verbesserung (p  < 0,01) im Vergleich zu den präoperativen Werten. Bis zur letzten Follow-up-Untersuchung waren keine signifikanten Unterschiede zwischen den beiden Gruppen in VAS- und ODI-Scores zu verzeichnen (p > 0,05). Des Weiteren bestand kein signifikanter Unterschied in der Inzidenz rezidivierender Bandscheibenvorfälle zwischen den beiden Gruppen (13,9% vs. 16,6%, p > 0,05). Bei 5 der Patienten wurde eine zweite Diskektomie oder eine Spondylodese durchgeführt. Das interspinöse Wallis-Device konnte bei LBSV das bereits gute klinische Ergebnis nach Diskektomie nicht verbessern und auch nicht die Rezidive des Bandscheibenvorfalls im aktuellen Follow-up-Intervall verhindern oder reduzieren. Vor dem operativen Eingriff gilt es, sorgfältig abzuwägen, ob das Device bei LBSV eingesetzt werden soll.

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Abbreviations

CT:

Computed tomography

LDH:

Lumbar disc herniation

MRI:

Magnetic resonance imaging

ODI:

Oswestry disability index

PEEK:

Polyetheretherketone

ROM:

Range of motion

TLIF:

Transforaminal lumbar interbody fusion

VAS:

Visual analog scale

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Authors and Affiliations

  1. Department of Orthopaedics, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, No. 100 Haining Road, 200080, Hongkou district, Shanghai, China

    Zihui Zhou, Xinmeng Jin, Congcong Wang & Lei Wang MD

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  1. Zihui Zhou
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  2. Xinmeng Jin
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  3. Congcong Wang
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  4. Lei Wang MD
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Corresponding author

Correspondence to Lei Wang MD.

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Conflict of interest

Z. Zhou, X. Jin, C. Wang and L. Wang declare that they have no competing interests.

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1975 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

Additional information

Zihui Zhou und Xinmeng Jin contributed equally to this work.

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Zhou, Z., Jin, X., Wang, C. et al. Wallis interspinous device versus discectomy for lumbar disc herniation. Orthopäde 48, 165–169 (2019). https://doi.org/10.1007/s00132-018-3639-z

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  • DOI: https://doi.org/10.1007/s00132-018-3639-z

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