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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/advagg_css\/css__ce2QY63WIanKyr8eSq7eavr1XQRRmFD6ZSmwpyJi8lM__zXwFqpqmxrZOXXcd_TpBQpjuELbmIP9wBR5UuTDWAO4__YJWWMMdfCJuAFm5cUEp88OsodhO3ZA-2lzRfoBsSlk4.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n\u003Cp id=\u0022p-1\u0022\u003EIn patients with moderate to severe lumbar spinal stenosis and back pain, use of an interlaminar stabilization device after surgical decompression achieves significantly superior clinical outcomes at 3-year follow-up compared with use of standard treatment with posterolateral fusion, suggesting increasingly favorable clinical and radiographic outcomes with ILS compared with fusion in these patients.\u003C\/p\u003E\n\u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003Elumbar spinal stenosis\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Einterlaminar stabilization device\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Eposterolateral fusion\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Espine conditions\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Eorthopaedics \u0026amp; sports medicine clinical trials\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Eorthopaedic procedures\u003C\/li\u003E\u003C\/ul\u003E\u003Cdiv class=\u0022section\u0022 id=\u0022sec-1\u0022\u003E\n\n\u003Cp id=\u0022p-2\u0022\u003EUse of an interlaminar stabilization device (ILS) after surgical decompression in patients with moderate to severe lumbar spinal stenosis (LSS) and axial back pain with or without spondylolisthesis achieves significantly superior clinical outcomes at 3-year follow-up compared with use of standard treatment with posterolateral fusion.\u003C\/p\u003E\n\u003Cp id=\u0022p-3\u0022\u003EAlthough fusion after decompression can provide relief from symptoms in the short term, recurring pain, pseudarthrosis, or degeneration at the adjacent levels may occur over the longer term. To evaluate and compare longer-term outcomes between the use of posterolateral fusion or ILS after decompression for LSS with back pain, Christopher A. Yeung, MD, Desert Institute for Spine Care, Phoenix, Arizona, USA, and colleagues conducted a prospective, randomized clinical trial that included 322 patients with moderate to severe LSS treated with either ILS (n\u2005=\u2005215) or fusion (n\u2005=\u2005107) after decompression.\u003C\/p\u003E\n\u003Cp id=\u0022p-4\u0022\u003EPatients were recruited from 21 sites in the United States under a FDA investigational device exemption. All patients in the study had LSS at 1 or 2 contiguous levels between L1 and L5 confirmed on magnetic resonance imaging, as well as a visual analog scale back score of \u2265\u200550 mm.\u003C\/p\u003E\n\u003Cp id=\u0022p-5\u0022\u003EThe primary clinical outcome of the study was a composite clinical success rate that included achieving \u2265\u200515-point improvement (out of 100) on the Oswestry Disability Index (ODI) at 24 months, no reoperations, and no use of lumbar steroid injections. This 3-year follow-up study was part of the FDA\u2019s postapproval requirement. Of the 322 patients in the study, 90.7% of the ILS group and 87.7% of the fusion group were available at 3-year follow-up.\u003C\/p\u003E\n\u003Cp id=\u0022p-6\u0022\u003EAt year 3, the study found that significantly more patients treated with ILS achieved composite clinical success compared with the fusion group (62.8% vs 47.4%; \u003Cem\u003EP\u2005\u003C\/em\u003E\u0026gt;\u2005.016). When broken down by individual clinical outcomes, the reoperation\/injection rate at 3 years was 25% and 24% for ILS and fusion patients, respectively. Among the patients who did not require reoperation or injection, those treated with ILS had significant improvement in ODI compared with those treated by fusion (90% vs 79%; \u003Cem\u003EP\u003C\/em\u003E\u2005=\u2005.011; \u003Ca id=\u0022xref-fig-1-1\u0022 class=\u0022xref-fig\u0022 href=\u0022#F1\u0022\u003EFigure 1\u003C\/a\u003E).\u003C\/p\u003E\n\u003Cdiv id=\u0022F1\u0022 class=\u0022fig pos-float  odd\u0022\u003E\u003Cdiv class=\u0022highwire-figure\u0022\u003E\u003Cdiv class=\u0022fig-inline-img-wrapper\u0022\u003E\u003Cdiv class=\u0022fig-inline-img\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/15\/7\/10\/F1.large.jpg?width=800\u0026amp;height=600\u0026amp;carousel=1\u0022 title=\u0022Percentage of Patients With \u0026#x2265; 15-Point Improvement in Oswestry Disability IndexILS, interlaminar stabilization device.Reproduced with permission from CA Yeung, MD.\u0022 class=\u0022fragment-images colorbox-load\u0022 rel=\u0022gallery-fragment-images-1743611576\u0022 data-figure-caption=\u0022Percentage of Patients With \u0026#x2265; 15-Point Improvement in Oswestry Disability IndexILS, interlaminar stabilization device.Reproduced with permission from CA Yeung, MD.\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003E\u003Cimg class=\u0022fragment-image\u0022 alt=\u0022Figure 1.\u0022 src=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/15\/7\/10\/F1.medium.gif\u0022\/\u003E\u003C\/a\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cul class=\u0022highwire-figure-links inline\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/15\/7\/10\/F1.large.jpg?download=true\u0022 class=\u0022highwire-figure-link highwire-figure-link-download\u0022 title=\u0022Download Figure 1.\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload figure\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/15\/7\/10\/F1.large.jpg\u0022 class=\u0022highwire-figure-link highwire-figure-link-newtab\u0022 target=\u0022_blank\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EOpen in new tab\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/16256\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003Cdiv class=\u0022fig-caption\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cspan class=\u0022fig-label\u0022\u003EFigure 1.\u003C\/span\u003E \u003Cp id=\u0022p-7\u0022 class=\u0022first-child\u0022\u003EPercentage of Patients With \u2265 15-Point Improvement in Oswestry Disability Index\u003C\/p\u003E\n\u003Cp id=\u0022p-8\u0022\u003EILS, interlaminar stabilization device.\u003C\/p\u003E\n\u003Cp id=\u0022p-9\u0022\u003EReproduced with permission from CA Yeung, MD.\u003C\/p\u003E\u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\n\u003Cp id=\u0022p-10\u0022\u003EWhen looking at radiographic change between the 2 cohorts, the study found no significant implant-level radiographic change in motion as measured by flexion\/extension radiographs in the ILS cohort (mean change at 3 years, \u20130.44\u00b0; \u003Cem\u003EP\u2005\u003C\/em\u003E=\u2005.14), but a significant reduction in motion at the implant level in the fusion cohort (mean change at 3 years, \u20132.75\u00b0; \u003Cem\u003EP\u2005\u003C\/em\u003E\u0026lt;\u2005.0001). The difference in radiographic change at 3 years between the 2 groups was significant (\u003Cem\u003EP\u2005\u003C\/em\u003E\u0026lt;\u2005.0001; \u003Ca id=\u0022xref-fig-2-1\u0022 class=\u0022xref-fig\u0022 href=\u0022#F2\u0022\u003EFigure 2\u003C\/a\u003E).\u003C\/p\u003E\n\u003Cdiv id=\u0022F2\u0022 class=\u0022fig pos-float  odd\u0022\u003E\u003Cdiv class=\u0022highwire-figure\u0022\u003E\u003Cdiv class=\u0022fig-inline-img-wrapper\u0022\u003E\u003Cdiv class=\u0022fig-inline-img\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/15\/7\/10\/F2.large.jpg?width=800\u0026amp;height=600\u0026amp;carousel=1\u0022 title=\u0022Mean (SD) Rotation at Baseline and Year 3ILS, interlaminar stabilization device.Reproduced with permission from CA Yeung, MD.\u0022 class=\u0022fragment-images colorbox-load\u0022 rel=\u0022gallery-fragment-images-1743611576\u0022 data-figure-caption=\u0022Mean (SD) Rotation at Baseline and Year 3ILS, interlaminar stabilization device.Reproduced with permission from CA Yeung, MD.\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003E\u003Cimg class=\u0022fragment-image\u0022 alt=\u0022Figure 2.\u0022 src=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/15\/7\/10\/F2.medium.gif\u0022\/\u003E\u003C\/a\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cul class=\u0022highwire-figure-links inline\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/15\/7\/10\/F2.large.jpg?download=true\u0022 class=\u0022highwire-figure-link highwire-figure-link-download\u0022 title=\u0022Download Figure 2.\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload figure\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/15\/7\/10\/F2.large.jpg\u0022 class=\u0022highwire-figure-link highwire-figure-link-newtab\u0022 target=\u0022_blank\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EOpen in new tab\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/16257\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003Cdiv class=\u0022fig-caption\u0022\u003E\u003Cspan class=\u0022fig-label\u0022\u003EFigure 2.\u003C\/span\u003E \u003Cp id=\u0022p-11\u0022 class=\u0022first-child\u0022\u003EMean (SD) Rotation at Baseline and Year 3\u003C\/p\u003E\n\u003Cp id=\u0022p-12\u0022\u003EILS, interlaminar stabilization device.\u003C\/p\u003E\n\u003Cp id=\u0022p-13\u0022\u003EReproduced with permission from CA Yeung, MD.\u003C\/p\u003E\u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\n\u003Cp id=\u0022p-14\u0022\u003ERadiographic analysis at 3 years shows adjacent level motion remains at preoperative levels in patients treated with ILS compared with significantly elevated adjacent level motion in patients treated by fusion. When looking only at the ILS group, the study also found that foraminal heights remained stable from preoperative to 3-year measurements (17.72 and 17.39 mm, respectively). Overall, these longer-term data suggest increasingly favorable clinical and radiographic outcomes with ILS compared with fusion in patients with moderate to severe LSS and back pain.\u003C\/p\u003E\n\u003C\/div\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2015 SAGE Publications\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/15\/7\/10.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_figures.js?nzlpv1\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzlpv1\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}