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Interspinous device versus laminectomy for lumbar spinal stenosis: a comparative effectiveness study.

Publication ,  Journal Article
Patil, CG; Sarmiento, JM; Ugiliweneza, B; Mukherjee, D; Nuño, M; Liu, JC; Walia, S; Lad, SP; Boakye, M
Published in: Spine J
August 1, 2014

BACKGROUND CONTEXT: Currently no studies directly compare effectiveness between interspinous devices (IDs) and laminectomy in lumbar spinal stenosis (LSS) patients. PURPOSE: To compare reoperations, complications, and costs between LSS patients undergoing ID placement versus laminectomy. STUDY DESIGN: Retrospective comparative study. PATIENT SAMPLE: The MarketScan database (2007-2009) was queried for adults with LSS undergoing ID placement as a primary inpatient procedure. OUTCOME MEASURES: Reoperation rates, complication rates, and costs. METHODS: Each ID patient was matched with a laminectomy patient using propensity score matching. Reoperations, complications, and costs were analyzed in patients with at least 18 months postoperative follow-up. The authors did not receive funding from any external sources for this study. RESULTS: Among 498 inpatients that underwent ID placement between 2007 and 2009; the average age was 73 years. The cumulative reoperation rates after ID at 12 and 18 months were 21% and 23%, respectively. The average inpatient hospitalization lasted 1.6 days with an associated cost of $17,432. Two propensity-matched cohorts of 174 patients that had undergone ID versus laminectomy were analyzed. Longer length of stay was observed in the laminectomy cohort (2.5 days vs. 1.6 days, p<.0001), whereas ID patients accrued higher costs at index hospitalization ($17,674 vs. $12,670, p=.0001). Index hospitalization (7.5% vs. 3.5%, p=.099) and 90-day (9.2% vs. 3.5%, p=.028) complications were higher in the laminectomy cohort compared with the ID cohort. The ID patients had significantly higher reoperation rates than laminectomy patients at 12 months follow-up (12.6% vs. 5.8%, p=.026) and incurred higher cumulative costs than laminectomy patients at 12 months follow-up ($39,173 vs. $34,324, p=.289). CONCLUSIONS: Twelve-month reoperation rates and index hospitalization costs were significantly higher among patients who underwent ID compared with laminectomy for LSS.

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Published In

Spine J

DOI

EISSN

1878-1632

Publication Date

August 1, 2014

Volume

14

Issue

8

Start / End Page

1484 / 1492

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Spinal Stenosis
  • Retrospective Studies
  • Reoperation
  • Prosthesis Implantation
  • Orthopedics
  • Middle Aged
  • Male
  • Lumbar Vertebrae
  • Length of Stay
 

Citation

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Patil, C. G., Sarmiento, J. M., Ugiliweneza, B., Mukherjee, D., Nuño, M., Liu, J. C., … Boakye, M. (2014). Interspinous device versus laminectomy for lumbar spinal stenosis: a comparative effectiveness study. Spine J, 14(8), 1484–1492. https://doi.org/10.1016/j.spinee.2013.08.053
Patil, Chirag G., J Manuel Sarmiento, Beatrice Ugiliweneza, Debraj Mukherjee, Miriam Nuño, John C. Liu, Sartaaj Walia, Shivanand P. Lad, and Maxwell Boakye. “Interspinous device versus laminectomy for lumbar spinal stenosis: a comparative effectiveness study.Spine J 14, no. 8 (August 1, 2014): 1484–92. https://doi.org/10.1016/j.spinee.2013.08.053.
Patil CG, Sarmiento JM, Ugiliweneza B, Mukherjee D, Nuño M, Liu JC, et al. Interspinous device versus laminectomy for lumbar spinal stenosis: a comparative effectiveness study. Spine J. 2014 Aug 1;14(8):1484–92.
Patil, Chirag G., et al. “Interspinous device versus laminectomy for lumbar spinal stenosis: a comparative effectiveness study.Spine J, vol. 14, no. 8, Aug. 2014, pp. 1484–92. Pubmed, doi:10.1016/j.spinee.2013.08.053.
Patil CG, Sarmiento JM, Ugiliweneza B, Mukherjee D, Nuño M, Liu JC, Walia S, Lad SP, Boakye M. Interspinous device versus laminectomy for lumbar spinal stenosis: a comparative effectiveness study. Spine J. 2014 Aug 1;14(8):1484–1492.
Journal cover image

Published In

Spine J

DOI

EISSN

1878-1632

Publication Date

August 1, 2014

Volume

14

Issue

8

Start / End Page

1484 / 1492

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Spinal Stenosis
  • Retrospective Studies
  • Reoperation
  • Prosthesis Implantation
  • Orthopedics
  • Middle Aged
  • Male
  • Lumbar Vertebrae
  • Length of Stay