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ObjectiveTo evaluate the effectiveness of the In- space (Synthes, Umkirch, Germany) and the correlation between radiographic parameters and clinical outcome in patients with lumbar spinal canal stenosis (LSS).MethodsBetween June 2009 and May 2013, 56 patients with LSS underwent In-space by one senior surgeon. All of the patients were evaluated both clinically and radiographic measurements before the procedure and each visit at the postoperative follow-up. Preoperative and postoperative X-ray imaging was performed before the procedure and at follow-up to assess the correlation with the clinical outcome. Radiological measurements and clinical outcomes were recorded to establish a relationship between the radiographic parameters and clinical outcome of this procedure. All patients had at least 2 years of follow-up.ResultsThe mean VAS score of back pain decreased significantly (p < 0.05).ConclusionsOur data suggest that percutaneous interspinous devices are a good alternative to treat LSS. The device offers significant decrease in back pain, leg pain and ODI score with 2-year lasting relief from symptoms. The increased intervertebral foramenal space explains the improvement of leg pain, but the mechanism of back pain relief remains unclear. A very weak correlation between the radiographic changes and improvement of pain was found.

Case: We present a case of progressive paraplegia because of extramedullary hematopoiesis and pathological vertebral fracture in thalassemia patient. The various surgical techniques including larger pedicle screws, bicortical fixation, and convergent direction to improve pullout strength had been used secondary to osteoporotic bone and kyphotic deformity. Conclusion: Prompt diagnosis and awareness of the compromised bone quality of the thalassemic patient is essential to guide the proper management and produce the desire outcomes.

Case: We presented a case of extension-distraction spine injury at lumbosacral junction in a patient with fused spine concomitant with a lumbosacral transitional vertebra. Detail of an exceedingly rare case of traumatic lumbosacral hyperextension-distraction fracture in the individual was described and reviewed. Conclusion: Although the occurrence of extension-distraction spine injury at lumbosacral junction is extremely rare, it can occur in some circumstances. Application of damage control spine concept including early definitive stabilization of spine fractures and minimally invasive spine surgery can give satisfactory outcomes in the polytraumatized patient.