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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: The spine journal : official journal of the North American Spine Society
August 2014

Currently no studies directly compare effectiveness between interspinous devices (IDs) and laminectomy in lumbar spinal stenosis (LSS) patients.To compare reoperations, complications, and costs between LSS patients undergoing ID placement versus laminectomy.Retrospective comparative study.The MarketScan database (2007-2009) was queried for adults with LSS undergoing ID placement as a primary inpatient procedure.Reoperation rates, complication rates, and costs.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.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).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

The spine journal : official journal of the North American Spine Society

DOI

EISSN

1878-1632

ISSN

1529-9430

Publication Date

August 2014

Volume

14

Issue

8

Start / End Page

1484 / 1492

Related Subject Headings

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

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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. The Spine Journal : Official Journal of the North American Spine Society, 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.The Spine Journal : Official Journal of the North American Spine Society 14, no. 8 (August 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. The spine journal : official journal of the North American Spine Society. 2014 Aug;14(8):1484–92.
Patil, Chirag G., et al. “Interspinous device versus laminectomy for lumbar spinal stenosis: a comparative effectiveness study.The Spine Journal : Official Journal of the North American Spine Society, vol. 14, no. 8, Aug. 2014, pp. 1484–92. Epmc, 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. The spine journal : official journal of the North American Spine Society. 2014 Aug;14(8):1484–1492.
Journal cover image

Published In

The spine journal : official journal of the North American Spine Society

DOI

EISSN

1878-1632

ISSN

1529-9430

Publication Date

August 2014

Volume

14

Issue

8

Start / End Page

1484 / 1492

Related Subject Headings

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