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Soft Stabilization With an Artificial Intervertebral Ligament in Grade I Degenerative Spondylolisthesis: Comparison With Instrumented Posterior Lumbar Interbody Fusion

Chan Shik Shim, Sang-Ho Lee, Sun-Hee Park and Ji-Hee Whang
International Journal of Spine Surgery January 2007, 1 (3) 118-124; DOI: https://doi.org/10.1016/SASJ-2006-0006-RR

Article Figures & Data

Figures

  • Figure 1
    Figure 1

    Diagram representing the radiographic measurement of slippage.

  • Figure 2
    Figure 2

    Intervertebral ligamentoplasty with an artificial ligament: (a) Artificial intervertebral ligament. (b) The ligament applied around the spinous processes of a spine model in a figure eight pattern. The crossing point of the ligament is sutured several times with nonabsorbable suture.

  • Figure 3
    Figure 3

    Postoperative anteroposterior view (a) and lateral view (b) of plain radiograph showing the artificial ligament applied around spinous processes. A radiopaque thread of barium-platinum cord makes the ligament visible in radiographs.

  • Figure 4
    Figure 4

    These x-rays are views from a 61-year-old man who underwent microdecompression and soft stabilization. Preoperative dynamic views (a, b) of plain lateral radiograph showed grade I degenerative spondylolisthesis. Postoperative dynamic views (c, d) taken 2 years after surgery showed preserved segmental motion and no further progression of slippage.

Tables

  • Table 1

    Patient Demographics and Preoperative Clinical Parameters

    Soft Stabilization (n = 17)PLIF (n = 19)Pa
    Age, y (range)60.2 (46–70)57 (43–67).09
    Sex, male:female8:96:13NA
    Follow-up, mo (range)16 (6–39)24 (6–39)NA
    ODI, % (range)55 (12–94)60 (22–88).43
    VAS, low-back pain (range)8.4 (1–10)8.8 (5–10).50
    VAS, leg pain (range)8.9 (2–10)9.3 (6–10).26
    Slippage, % (range)17.9 (11.6–25)18.8 (11.5–25).56

    • Note. PLIF = posterior lumbar interbody fusion; NA = not applied; ODI = Oswestry Disability Index; VAS = visual analog scale.

    • ↵a Wilcoxon rank sum test.

  • Table 2

    Postoperative Clinical and Radiological Parameters

    Soft Stabilization (n = 17)PLIF (n = 19)Pa
    ODI, % (range)25 (2–64)28 (2–74).74
    VAS, back pain (range)4.1 (0–9)4.1 (1–10).84
    VAS, leg pain (range)2.2 (0–7)2.6 (0–10).67
    Subjective improvement rate, % (range)74.7 (50–100)69.9 (0–80).96
    Operation time, min (range)101 (60–180)216 (135–495)<.05
    Blood loss, mL (range)261 (150–450)827 (450–1250)<.05
    Slippage, % (range)17.6 (8.2–29.6)4.2 (0–17.6)<.01

    • Note. PLIF = posterior lumbar interbody fusion; ODI = Oswestry Disability Index; VAS = visual analog scale.

    • ↵a Wilcoxon rank sum test.

  • Table 3

    Patients’ Satisfaction With Surgical Procedure

    No. (%)
    GroupnVery SatisfiedSatisfiedDissatisfiedVery Dissatisfied
    Soft stabilization174 (23.5)12 (70.6)1 (5.9)0 (0)
    PLIF195 (26.3)11 (57.9)2 (10.5)1 (5.3)
    Total369 (25)23 (63.9)3 (8.3)1 (2.8)

    • Note. PLIF = posterior lumbar interbody fusion.

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Soft Stabilization With an Artificial Intervertebral Ligament in Grade I Degenerative Spondylolisthesis: Comparison With Instrumented Posterior Lumbar Interbody Fusion
Chan Shik Shim, Sang-Ho Lee, Sun-Hee Park, Ji-Hee Whang
International Journal of Spine Surgery Jan 2007, 1 (3) 118-124; DOI: 10.1016/SASJ-2006-0006-RR
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