Evidence-Based Recommendations for Spine Surgery

Alexander R. Vaccaro, MD, PhD, MBA; Charles G. Fisher, MD; Srinivas K. Prasad, MD; Alpesh A. Patel, MD, FACS; John Chi, MD, MPH; Kishore Mulpuri, MBBS, MHSc; Kenneth C. Thomas, MD, MHSc; Peter G. Whang, MD, FACS


Spine. 2020;45(21):E1441-E1448. 

In This Article

Recommendation Regarding Impact on Clinical Practice

Although there have been a number of published studies comparing lumbar decompression and fusion to decompression with interlaminar stabilization, the authors do address a void in the literature by assessing the clinical and radiographic outcomes of a population of patients with moderate-to-severe stenosis randomly assigned to undergo decompression with or without the implantation of a Coflex device. Despite the novel objectives of this trial, there are still various inherent methodological concerns related to subject recruitment, selection bias, lack of blinding, and industry sponsorship. Until the results of an independently funded, multicenter, blinded investigation are available in the future, we would not recommend any changes to clinical practice based upon these findings.