1 2 0 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • J U L Y 2 0 1 6
When is a fusion fix necessary,
and when will decompression
do the job on its own? While
lumbar fusion is often per-
formed in addition to decom-
pression surgery when treating
spinal stenosis, 2 studies pub-
lished in a recent issue of the
New England Journal of
Medicine suggest that fusion's
effectiveness and ultimate
value in relieving lower back
pain may be limited unless certain conditions are present.
In one of the studies, patients whose compressed nerves were accom-
panied by misaligned vertebrae (lumbar spondylolisthesis) responded
better to fusion than decompression, reporting a higher quality of life as
much as 4 years after their surgery. The patients who received fusion
were also less likely to require a follow-up surgery than those who
received decompression, say researchers at the Lahey Hospital and
Medical Center's Spine Research Center in Burlington, Mass.
(osmag.net/9xDNMw).
In the other study, stenosis patients in whom the narrowing of the
spinal canal was not complicated by misaligned vertebrae saw no differ-
ence between the results of decompression surgery or decompression
with fusion. Quality of life and the ability to walk at 2 and 5 years post-op
were the same, and 20% of both groups required follow-up surgery. In
fact, researchers at the Stockholm Spine Center in Sweden say the
decompression-and-fusion group required more OR time, lost more
blood, had longer hospital stays and rang up higher surgical costs.
(osmag.net/QWgG8g). — David Bernard
SPINE SUPPORT
When is Fusion Most Effective?
• THE FIX IS IN Minimally invasive techniques, along with imaging and neuromon-
itoring technology, make outpatient fusion a practical prospect.
