The Efficacy of Lumbar Discectomy and Single Level Fusion for Spondylolisthesis: Neuropoint-SD Registry Initial Results

Zoher Ghogawala, MD1, Christopher Shaffrey, MD1, Anthony Asher, MD1, Robert Heary, MD1, Steven Dante, MD1, John Hurlbert, MD1, Andrea Douglas, MD1, Subu Magge, MD1, Praveen Mummaneni, MD1, Joseph Cheng, MD1, Justin Smith, MD1, Michael Kaiser, MD1, Khalid Abbed, MD1, Daniel Sciubba, MD1, Daniel Resnick, MD1

1Greenwich, CT United States

Keywords: registry, spinal fusion, lumbar diskectomy, outcome, spondylolisthesis

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       Multi-center registry data will become increasingly impotant for outcomes research.
     The aim was to establish a multi-center cooperative research group to demonstrate the feasibility of developing a registry to assess the efficacy of common lumbar spinal procedures.
     211 patients were screened and 204 were enrolled from 13 academic and community sites (mean 16 patients/ site) over 1 year. Mean age: 46.0 years for lumbar discectomy (N=156; 48% female) ; 58.3 years for lumbar spondylolisthesis (N=48 patients; 60% female).
     A prospective 13-site registry study, conducted over 1 year, collected data from unselected patients undergoing lumbar discectomy or single-level fusion for spondylolisthesis. The goal was to enroll 200 patients. Subjects completed SF 36 and ODI scales pre-operatively, and 3, 6, and 12 months post-operatively. All patient data was entered into a secure HIPPA compliant internet-based data management platform.
     There was 94% compliance with the collection of patient-reported outcomes data. Eleven complications (5.4%) reported within 1 month of surgery: 4 re-operations and 7 minor complications. At 3 months: lumbar discectomy had 26-point improvement in ODI score (46 to 20) and 33-point improvement in SF-36 physical function score (42 to 75) (P<0.001). Single level fusion for lumbar spondylolisthesis had 17-point improvement in ODI score (44 to 27) and 24-point improvement in SF-36 physical function score (47 to 61) (P<0.001). At 6 months, similar results were obtained (P<0.001).
     This is study evaluated non-randomized data.
     It is feasible to build a national spine registry for the collection of prospective data.
     Initial results from Neuropoint SD suggest that both lumbar discectomy and single-level spinal fusion for spondylolisthesis were highly effective in actual practice.


Project Roles:

Z. Ghogawala (), C. Shaffrey (), A. Asher (), R. Heary (), S. Dante (), J. Hurlbert (), A. Douglas (), S. Magge (), P. Mummaneni (), J. Cheng (), J. Smith (), M. Kaiser (), K. Abbed (), D. Sciubba (), D. Resnick ()