Abstract
Introduction The purpose of this paper is to evaluate Non-Fusion Stabilisation in a group of specific mechanical pathologies including degenerative spondylolisthesis, where conjecture remains as to the place and appropriateness of Spinal Fusion. Patients were provided with verbal information, a model, and written information including not only information from the company itself but a written information sheet and a copy of the article by Senegas (Eur Spine J 2002) on the Wallis Implant® (Spine Next, Bordeaux, France).
Methods 72 patients had non-fusion stabilising procedures using the Wallis PEEK and Polyester implant over a period from May 2003 until the 28th February 2005, and were prospectively followed for this review. Problems with the device, specific and non-specific postoperative complications, length of stay post-operatively and patient satisfaction were assessed.
Results 45 of the 72 patients had a follow-up of six months or more, and 21 of those 45 had a follow-up of greater than twelve months. There were no device failures and minimal complications.
Assessment by VAS and Oswestry Disability Questionnaire showed improvement across all groups. Pre-op ODQ (mean 49.35, SD 16.55) decreased at 6 months (mean 26.00, SD 25.85) and at 12 months (mean 24.18, SD 19.50). This was significant (p< .001). Pre-op VAS (mean 69.54, SD 19.80) decreased at 6 months (mean 26.00, SD 25.85) and at 12 months (mean 28.50, SD 22.00). This was significant (p< .001).
Discussion In this study it seems that non-fusion stabilisation may be a simple and relatively uncomplicated alternative to fusion surgery in the groups discussed. Whilst one long term study has shown excellent results, the patient groups were different and the implant itself was metallic rather than PEEK.¹ Anticipated longer-term problems with non-fusion stabilisation are possible loss of stabilisation, and perhaps increasing kyphosis. Obviously longer follow-up is required to assess long-term durability and problems. Non-Fusion Stabilisation seems worthy of consideration in some patient groups presented.
The abstracts were prepared by Professor Bruce McPhee. Correspondence should be addressed to him at Orthopaedics Division, The University of Queensland, Clinical Sciences Building, Royal Brisbane & Women’s Hospital, Herston, Qld, Australia
