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Show THE UNIVERSITY OF UTAH HEALTH SCIENCES LEAP PROGRAM TREATMENT FAILURES OF INTERSPINOUS PROCESS SPACERS DEVICE PLACEMENT AND LAMINECTOMY WITH FUSION IN PATIENTS WITH SPINAL STENOSIS AND LUMBAR DEFORMITY Anna Gallegos, Megan Galane, Kimberly Vargas, (Prokopis Annis, Michael D. Daubs, Brandon D. Lawrence, Darrel S. Brodke) Department of Orthopaedics-Spine University of Utah Introduction: Lumbar spinal stenosis with associated grade 1 spondylolisthesis or mild scoliosis are degenerative conditions that are on the rise due to our population becoming older. Laminectomy with fusion is the gold standard treatment for this condition. Interspinous Process Spacers (ISP) has been proposed recently as a less invasive alternative, although studies comparing these surgeries have not been conducted. This study compares 2 treatment options for patients with lumbar spinal stenosis with mild deformity to evaluate early treatment failures, survivorship, and clinical outcomes. Methods: This retrospective study reviewed 66 patients, with a mean age of 72.5 years, and minimum 2 year follow-up. Patients presented with degenerative grade 1 spondylolisthesis or scoliosis with less than a 25 degree curve. Early treatment failure was defined as return to the operative room within 2 years of the initial surgery for same level recurrence or adjacent segment disease. Survivorship was reviewed by a Kaplan Meier analysis showing h o w long patients could go without revisions. Visual Analog Scales and satisfaction questionnaires were utilized to review clinical outcomes. Results: Early failures were higher (33%) in the ISP group as compared with the LF group (13%). All early ISP failures were due to same level recurrence while all LF early failures were because of adjacent segment disease. The overall failure rate at the final follow-up (62 months) was higher for the ISP group (48%) as compared to the LF group(24%)Also survivorship and satisfaction rate were higher in the LF group. Conclusion: ISP treatment was associated with a higher early recurrence rate with no adjacent segment disease. All LF failures were associated with adjacent segment disease, and no same level recurrence. LF treatment was associated with greater patient satisfaction, survivorship, and less final failures. These results should be considered for treatment of patients with lumbar spinal stenosis and deformity. Anna Gallegos Megan Galane Prokopis Annis 159 |