Clinical and radiological results of non-fusion by static interspinous spacer
Main Article Content
Keywords
Lumbosacral region, Lumbar vertebrae, Peripheral nervous system
Abstract
Background: The aim of this paper is to demonstrate the clinical and radiological results of non-fusion in patients with degenerative disc disease and lumbar by placing static interspinous spacer.
Methods: A retrospective study was made in the period between January 2010 and January 2013, 130 patients were treated by placing static interspinous spacer. Patients were divided into: Group 1 (treated for diagnosis of degenerative lumbar spinal stenosis), and group 2 (those diagnosed with lumbar disc herniation). It is improving pain by visual analog scale (VAS), functional improvement based on the Oswestry scale (ODI) and radiological outcome at 6,12 and 24 months was evaluated.
Results: 57 female patients and 73 male were included. The most affected segments were L4 - L5 and L5 - S1. In Group 1, there was improvement in pain (VAS) at 6 months to 2 points which was maintained through 12 months and 24 months was found in 4 points. Functional improvement (ODI) at 6 and 12 months remained 13 points and 24 points and 21 months in group 2: VAS 2.7, 3, 3.5 and ODI 15 respectively at 6 and 12 months; at 24 months was found in 20 points. There were no fatal complications in 1.5% in both groups. Regarding radiological changes increased the diameter foraminal which was held at the 6, 12 and 24 month follow-up.
Conclusions: The interspinous device is an effective alternative treatment for lumbar degenerative disc disease and because it was associated with significantly improved lumbar pain and return to work activity.
References
Yu SW, Yen CY, Wu CH, Kao FC, Kao YH, Tu YK. Radiographic and clinical results of posterior dynamic stabilization for the treatment of multisegment degenerative disc disease with a minimum follow-up of 3 years. Arch Orthop Trauma Surg. 2012;132:583-9.
Hilibrand AS, Robbins M. Adjacent segment degeneration and adjacent segment disease: The consequences of spinal fusion? Spine J. 2004;4:190S-4S.
Sénégas J, Vital JM, Pointillart V, Mangione P. Clinical evaluation of a lumbar interspinous dynamic stabilization device (the Wallis system) with a 13-year mean follow-up. Neurosurg Rev. 2009;32(3):335-41.
Wilke HJ, Drumm J, Häussler K, Mack C, Steudel WI, Kettler A. Biomechanical effect of different lumbar interspinous implants on flexibility and intradiscal pressure. Eur Spine J. 2008;17(8):1049-56.
Sobottke R, Schlüter-Brust K, Kaulhausen T, Rollinghoff M, Joswig R, Stutzer H et al. Interspinous implants (X Stop, Wallis, Diam) for the treatment of LSS: is there a correlation between radiological parameters and clinical outcome? Eur Spine J. 2009;18:1494-503.
Korovessis P, Repantis T, Zacharatos S, Zafiropopulos A. Does Wallis implant reduce adjacent segment degeneration above lumbosacral instrumented fusion? Eur Spine J. 2009;18(10):830-40.
Mayoux-Benhamou MA, Revel M, Aaron C, Chomette G, Amor B. A morphometric study of the lumbar foramen: influence of flexion-extension movements and of isolated disc collapse. Surg Radiol Anat. 1989;11(2):97-102.
Schmid MR, Stucki G, Duewell S et al. Changes in cross-sectional measurements of the spinal canal and intervertebral foramina as a function of body position: in vivo studies on an open-configuration MR system. AJR Am J Roentgenol. 1999;172:1095-1102.
Swanson KE, Lindsey DP, Hsu KY, Zucherman JF, Yerby SA. The effects of an interspinous implant on intervertebral disc pressures. Spine. 2003;28:26-32.
Patel VV, Whang PG, Haley TR, Bradley D, Nunley PD, Davis RP et al. Superion interspinous process spacer for intermittent neurogenic claudication secondary to moderate lumbar spinal stenosis. Spine. 2015;40:275-282.
Yun-qi J, Wu C, Hui-Ren W, Ruo-yu L, Xi-lei L, Jian D. Minimum 5 year follow-up of multi-segmental lumbar degenerative disease treated with discectomy and the Wallis interspinous device. Journal of Clinical Neuroscience. 2015;22:1144-1149.
Lafage V, Gangnet N, Sénégas J et al. New interspinous implant evaluation using an in vitro biomechanical study combined with a finite-element analysis. Spine. 2007;32:1706-13.
Boeree N. Wallis-results of prospective international study-2 year follow-up. 12th International Meeting on Advanced Spinal Techniques (IMAST). Banff, Alberta, Canada. July, 2005.