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Pinter ZW, Freedman BA, Nassr A, Sebastian AS, Coric D, Welch WC, Steinmetz MP, Robbins SE, Ament J, Anand N, Arnold P, Baron E, Huang J, Whitmore R, Whiting D, Tahernia D, Sandhu F, Chahlavi A, Cheng J, Chi J, Pirris S, Groff M, Fabi A, Meyer S, Kushwaha V, Kent R, DeLuca S, Smorgick Y, Anekstein Y. A Prospective Study of Lumbar Facet Arthroplasty in the Treatment of Degenerative Spondylolisthesis and Stenosis: Results from the Total Posterior Spine System (TOPS) IDE Study. Clin Spine Surg 2023; 36:E59-E69. [PMID: 36191093 PMCID: PMC9949521 DOI: 10.1097/bsd.0000000000001365] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 05/18/2022] [Indexed: 11/26/2022]
Abstract
STUDY DESIGN Prospective randomized Food and Drug Administration investigational device exemption clinical trial. OBJECTIVE The purpose of the present study is to report the 1-year clinical and radiographic outcomes and safety profile of patients who underwent lumbar facet arthroplasty through implantation of the Total Posterior Spine System (TOPS) device. SUMMARY OF BACKGROUND DATA Lumbar facet arthroplasty is one proposed method of dynamic stabilization to treat grade-1 spondylolisthesis with stenosis; however, there are currently no Food and Drug Administration-approved devices for facet arthroplasty. METHODS Standard demographic information was collected for each patient. Radiographic parameters and patient-reported outcome measures were assessed preoperatively and at regular postoperative intervals. Complication and reoperation data were also collected for each patient. RESULTS At the time of this study, 153 patients had undergone implantation of the TOPS device. The mean surgical time was 187.8 minutes and the mean estimated blood loss was 205.7cc. The mean length of hospital stay was 3.0 days. Mean Oswestry Disability Index, Visual Analog Score leg and back, and Zurich Claudication Questionnaire scores improved significantly at all postoperative time points ( P >0.001). There were no clinically significant changes in radiographic parameters, and all operative segments remained mobile at 1-year follow-up. Postoperative complications occurred in 11 patients out of the 153 patients (7.2%) who underwent implantation of the TOPS device. Nine patients (5.9%) underwent a total of 13 reoperations, 1 (0.6%) of which was for device-related failure owing to bilateral L5 pedicle screw loosening. CONCLUSIONS Lumbar facet arthroplasty with the TOPS device demonstrated a statistically significant improvement in all patient-reported outcome measures and the ability to maintain motion at the index level while limiting sagittal translation with a low complication rate.
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Affiliation(s)
| | | | - Ahmad Nassr
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN
| | | | - Domagoj Coric
- Carolinas Neurosurgery & Spine Associates, Charlotte, NC
| | - William C. Welch
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | | | | | | | - Neel Anand
- Cedars-Sinai Medical Center, Los Angeles, CA
| | | | - Eli Baron
- Cedars-Sinai Medical Center, Los Angeles, CA
| | | | | | | | | | - Faheem Sandhu
- MedStar Georgetown University Hospital, District of Columbia, WA
| | - Ali Chahlavi
- Ascension St. Vincent’s Southside, Jacksonville, FL
| | | | - John Chi
- Brigham and Women’s Hospital, Boston, MA
| | | | | | - Alain Fabi
- Bronson Methodist Hospital, Kalamazoo, MI
| | | | | | | | - Steven DeLuca
- Orthopedic Institute of Pennsylvania, Harrisburg, PA
| | - Yossi Smorgick
- Shamir Medical Center, Zerifin, Israel, affiliated with the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv Israel
| | - Yoram Anekstein
- Shamir Medical Center, Zerifin, Israel, affiliated with the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv Israel
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