Decompression and Coflex interlaminar stabilization compared with decompression and instrumented spinal fusion for spinal stenosis and low-grade degenerative spondylolisthesis: two-year results from the prospective, randomized, multicenter, Food and Drug Administration Investigational Device Exemption trial.
By most definitions, this is a good example of a randomized control trial (RCT). The study populations were well matched and the outcomes were standardly measured. The follow-up rate was greater than 80%. The inclusion criteria included the presence of back pain (VAS of 5/10 or more), along with spinal stenosis and up to grade […]
This paper is a retrospective review on 348 consecutive patients who had lumbar discectomy surgery between 1973 and 1979 by the orthopedic department of Federico II Hospital in Naples, Italy. Seven different surgeons participated in the surgical treatments. Two Hundred One (201) patients agreed to participate in follow-up, either by mail or by an in […]
ISSLS Prize winner: The anatomy of failure in lumbar disc herniation: an in vivo, multimodal, prospective study of 181 subjects.
Conventional wisdom states that the mode of failure and cause of disc herniation is secondary to a rupture of nucleus material through the annulus fibrosis. In this paper, the senior author prospectively defined the nature of intraoperatively identified disc herniations in 181 consecutive patients qualified for inclusion. Inclusion criteria included requiring a single level lumbar […]
1997 Volvo Award winner in clinical studies. Degenerative lumbar spondylolisthesis with spinal stenosis: a prospective, randomized study comparing decompressive laminectomy and arthrodesis with and without spinal instrumentation.
This prominent historical study by Fischgrund et al published in 1997, was a well-controlled randomized trial looking at both clinical and radiographic outcomes of lumbar laminectomy with arthrodesis surgery in patients with degenerative spondylolisthesis and spinal stenosis. Patients in this study (N=68) were randomly assigned to two treatment groups; Lumbar laminectomy with posterolateral intertransverse process […]
Abnormal magnetic-resonance scans of the cervical spine in asymptomatic subjects. A prospective investigation.
This classic paper published by Boden et al (1990) is a parallel study to the one investigating abnormal magnetic resonance imaging scans of the lumbar spine in asymptomatic subjects that was published the same year. This study included 63 asymptomatic volunteers who were screened and underwent an MRI scan of the cervical spine. The MRI […]
Radiculopathy and myelopathy at segments adjacent to the site of a previous anterior cervical arthrodesis.
This study by Hilibrand et al remains one of the most widely cited studies in regarding adjacent segment disease following anterior cervical discectomy and fusion. The study population of 374 consecutive patients (409 fusions) were followed prospectively for the development of adjacent segment disease, as defined by symptomatic radiculopathy or myelopathy, at an adjacent segment […]
Degenerative lumbar spondylolisthesis with spinal stenosis. A prospective study comparing decompression with decompression and intertransverse process arthrodesis.
This study published by the late Dr. Harry Herkowitz, from William Beaumont Hospital in 1991, is one of the most influential papers of its time. His contributions to the field of degenerative spinal surgery continue to influence current research and treatment of many spinal disorders. This paper in particular, has been referenced over 800 times […]
Initial outcome and efficacy of “kyphoplasty” in the treatment of painful osteoporotic vertebral compression fractures.
Kyphoplasty was first described in 1987. This paper by Lieberman et al was a phase I efficacy study looking at the use of kyphoplasty in the treatment of symptomatic osteoporotic compression fractures. The study included 70 consecutive kyphoplasty procedures in 30 patients over the course of 11 months. Based on a review of the study, […]
This paper published in 1995 is a case series of 261 patients that have had either posterior or anterior iliac crest harvesting for spinal fusion. With current utilization of bone graft substitutes including bone marrow aspiration and BMP, many of the more recently trained spine surgeons may not have had the experience of dealing with complications and […]