Evaluation of the Efficacy and Safety of FFX Facet Cages Compared With Pedicle Screw Fixation in Patients With Lumbar Spinal Stenosis: A Long-Term Study.

Autor: Houari O; Department of Neurosurgery, Hôpitaux Civils de Colmar, Colmar, France., Douanla A; Department of Neurosurgery, Hôpitaux Civils de Colmar, Colmar, France., Ben Ammar M; Department of Neurosurgery, Hôpitaux Civils de Colmar, Colmar, France., Benmekhbi M; Department of Neurosurgery, Hôpitaux Civils de Colmar, Colmar, France., Mortada J; Department of Neurosurgery, Hôpitaux Civils de Colmar, Colmar, France., Lungu G; Department of Neurosurgery, Hôpitaux Civils de Colmar, Colmar, France., Magheru C; Department of Neurosurgery, Hôpitaux Civils de Colmar, Colmar, France., Voirin J; Department of Neurosurgery, Hôpitaux Civils de Colmar, Colmar, France., Lebedinsky PA; Department of Diagnostic and Interventional Neuroradiology, Hôpitaux Civils de Colmar, Colmar, France., Musacchio M; Department of Diagnostic and Interventional Neuroradiology, Hôpitaux Civils de Colmar, Colmar, France., Bolognini F; Department of Diagnostic and Interventional Neuroradiology, Hôpitaux Civils de Colmar, Colmar, France., Srour R; Department of Neurosurgery, Hôpitaux Civils de Colmar, Colmar, France.
Jazyk: angličtina
Zdroj: Clinical spine surgery [Clin Spine Surg] 2024 Oct 15. Date of Electronic Publication: 2024 Oct 15.
DOI: 10.1097/BSD.0000000000001704
Abstrakt: Study Design: Hybrid retrospective/prospective study.
Objective: The study evaluated the long-term safety and efficacy of the FFX facet cage versus pedicle screw (PS) fixation in patients with lumbar spinal stenosis (LSS).
Summary of Background Data: A previous single-arm study reported on the safety, fusion rate, and patient outcomes associated with the use of the FFX facet cage in patients with lumbar spinal stenosis. There are no long-term studies reporting outcomes with this device compared with the use of pedicle screw fixation.
Methods: Following a medical records review, subjects meeting the inclusion and exclusion criteria were consented to and enrolled in the prospective arm of the study. CT scans and dynamic X-rays were performed to assess fusion rates, range of motion, and translation. Adverse events during the 2-year post-index procedure were also analyzed. Preoperative and 2+ year Visual Analogue Scale (VAS) back and leg scores and Oswestry Disability Index (ODI) were also obtained.
Results: A total of 112 subjects were enrolled with 56 patients included in the PS and FFX groups. Mean age was 63.1±11.2 and 67.1±10.9 years and the mean number of levels operated was 1.8±0.8 and 2.3±1.0, respectively, for the PS and FFX groups. There was no difference between the 2 groups for the primary composite fusion endpoint assessed with the FFX group achieving a 91% bony facet fusion rate. There was also no difference in postoperative complications or adverse events during the 2-year follow-up period. A higher percentage of patients in the PS group (10.7%) required reoperation compared with the FFX group (3.6%). Although both groups experienced significant improvements in VAS and ODI scores versus preoperative assessment, there was no difference between the 2 groups.
Conclusion: The present study documents the long-term safety and efficacy of the FFX device in patients with LSS with a reduction in reoperation rate when compared with PS fixation.
Level of Evidence: Level III.
Competing Interests: O.H. reports receiving funding from SC Medica to support data curation for the present work. R.S. reports having a relative employed by SC Medica and is a designer for the patents associated with the FFX device. The remaining authors declare no conflict of interest.
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Databáze: MEDLINE