Mini-invasive Lumbar Arthrodesis in Ambulatory
Condition: Lumbar Spine Degeneration
Study type: Interventional

Summary: 
      Degenerative lumbar pathologies are characterised by functional impairment and the occurrence
      of severe chronic pain and disability Arthrodesis of the lumbar spine is a common surgery for
      the treatment of degenerative lumbar pathologies. It is commonly performed during a hospital
      stay that can vary from 3 to 7 days. The development of mini-invasive techniques and the
      development of the Improved Rehabilitation after Surgery programmes, has considerably reduced
      the hospital stay of the patients. It is possible that in the future mini-invasive lumbar
      arthrodesis will be performed on an ambulatory as a standard procedure, but its safety,
      efficacy and patient satisfaction must be proven and validated.
    

Detailed description: 
      Degenerative lumbar disease (DLD) is a condition of increasing frequency, affecting millions
      of patients worldwide. They are characterised by functional impairment and the occurrence of
      severe chronic pain and disability.

      Arthrodesis of the lumbar spine is a common surgery for the treatment of DLD. It is commonly
      performed during a hospital stay that can vary from 3 to 7 days. The advent of mini-invasive
      techniques and the development of Improved Rehabilitation after Surgery program has made it
      possible to considerably reduce the duration of hospitalization of patients with a high rate
      of satisfaction, a reduction in costs and without increasing morbidity. In spinal surgery,
      decompression procedures such as discectomy and lumbar recalibration are frequently performed
      on an ambulatory. The first American studies with a low level of evidence on the management
      of mini-invasive lumbar arthrodesis are beginning to appear. It is quite possible that in the
      future this type of procedure will be carried out on an ambulatory as a standard procedure,
      but its safety, efficacy and patient satisfaction must be proven and validated. In the United
      States, 23-hour hospitalizations are considered as ambulatory procedures, whereas in France,
      ambulatory is qualified as such when the patient is admitted and discharged in the same day.

      The study population was patients who had failed medical treatment (analgesics and
      rehabilitation) for more than three months and who required a mono-segmental arthrodesis
      procedure for the management of their lumbar-radiculalgia.
    

Intervention name(s): mini-invasive lumbar arthrodesis
Intervention type(s): Procedure
Intervention description(s): The mini-invasive posterior approach is performed using a trans-muscular Wiltse approach. Pedicle screws, neurological decompression and intersomatic cage placement are performed.
The mini-invasive anterior approach is performed via a left retroperitoneal pararectal approach. After complete discectomy, an intersomatic cage stabilised by a screwed plate will be placed.
Intervention model: Single Group Assignment
Intervention model description: Single-centre, pilot study evaluating the feasibility, difficulties and morbidity of ambulatory lumbar arthrodesis
Masking: None (Open Label)
Primary purpose: Other
Keywords: mini-invasive lumbar arthrodesis