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Seven years follow-up for total lumbar facet joint replacement (TOPS) in the management of lumbar spinal stenosis and degenerative spondylolisthesis

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Abstract

Purpose

To evaluate the feasibility and clinical improvement of a total posterior arthroplasty system in the surgical management of lumbar degenerative spondylolisthesis and or spinal stenosis.

Methods

During a 1-year period (June 2006 to July 2007), ten patients were enrolled in a non-randomized prospective clinical study. The primary indication was neurogenic claudication due to spinal stenosis with single-level degenerative spondylolisthesis. Patients were evaluated with X-rays and MRI scans, visual analog scale (VAS) for back and leg pain, the Oswestry disability questionnaire, and the SF-36 health survey preoperatively, at 6 weeks, 3 months and 6 months and at 1, 2, 3 and 7 years postoperatively.

Results

The VAS score for back pain dropped from 56.2 preoperatively to 12.5 at 6 weeks and 19 at 7 years follow-up. The VAS score for worse leg pain dropped from 83.5 before surgery to 13 at 6 weeks and 8.8 at 7 years follow-up. The ODI dropped from 49.1 preoperatively to 13.5 at 6 weeks and 7.8 at 7 years follow-up. MRI examination at 7 years after surgery did not demonstrate stenosis adjacent to the stabilized segment. Spondylolisthesis did not progress in any of the cases. One patient had a symptomatic L3–L4 far lateral disc herniation 5 years after surgery whose symptoms resolved with non-operative treatment. In one patient, conversion to posterolateral fusion was performed due to an early device malfunction.

Conclusion

In patients with spinal stenosis and degenerative spondylolisthesis, decompression and posterior arthroplasty with the TOPS System can maintain clinical improvement and radiologic stability over time.

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Conflict of interest

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Author information

Authors and Affiliations

  1. Department of Orthopedic Surgery, Assaf Harofeh Medical Center, Zerifin, Israel

    Yigal Mirovsky

  2. The Spine Unit, Assaf Harofeh Medical Center, Zerifin, 70300, Israel

    Yoram Anekstein & Yossi Smorgick

  3. Affiliated with the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel

    Yoram Anekstein, Yossi Smorgick & Yigal Mirovsky

  4. Israel Spine Center at Assuta Hospital, Tel Aviv, Israel

    Yizhar Floman, Nahshon Rand & Michael Millgram

Authors
  1. Yoram Anekstein
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  2. Yizhar Floman
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  3. Yossi Smorgick
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  4. Nahshon Rand
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  5. Michael Millgram
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  6. Yigal Mirovsky
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Corresponding author

Correspondence to Yossi Smorgick.

Additional information

The study was approved by the Institutional Review Board of Assaf Harofeh Medical Center.

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Anekstein, Y., Floman, Y., Smorgick, Y. et al. Seven years follow-up for total lumbar facet joint replacement (TOPS) in the management of lumbar spinal stenosis and degenerative spondylolisthesis. Eur Spine J 24, 2306–2314 (2015). https://doi.org/10.1007/s00586-015-3850-0

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  • DOI: https://doi.org/10.1007/s00586-015-3850-0

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