A Novel Technique of Intra-Spinous Process Injection of PMMA to Augment the Strength of an Inter-Spinous Process Device Such as the X STOP

Abstract

This first reported technique of posterior element vertebroplasty may increase the indications and success for patients with decreased BMD who seek an interspinous implant such as the X STOP. A possible role may exist in increasing the effectiveness of such devices. However, clinical trials have yet been performed. These results demonstrate that PMMA injection in the spinous processes is effective in increasing resistance to compressive forces in an X STOP model.

Posterior Vertebral Arch Cement Augmentation (Spinoplasty) to Prevent Fracture of Spinous Processes after Interspinous Spacer Implant

“…[4][5][6]9,10,12 Elderly individuals are often affected by bone fragility even without a definite diagnosis of osteoporosis. Hence, they should be considered at risk for this procedure.…”

“…From June 2007 to March 2010, we performed, at a single center, interspinous spacer implantation (Aperius PercLID, Medtronic) 3,4,[8][9][10]13,14 in all eligible patients with INC and radiologic diagnosis of central canal and/or foraminal stenosis. All patients underwent an MR imaging or CT study of the lumbar spine preoperatively, to confirm stenosis of the central canal and/or foramina and to diagnose the most severely affected levels.…”

“…6,11 Consequently, this treatment is contraindicated in patients with osteoporosis. [4][5][6]9,10,12 Additionally, due to the frequent bone mass loss, advanced age (older than 75 years) can be considered a risk factor as well.…”

“…9 At our center, since June 2007, we have been treating eligible patients with INC by implanting interspinous spacers and have been encountering symptomatic postimplantation delayed fractures (Fig 1).…”

“…Additional interspinous spacer devices were subsequently proposed on the basis of the same principles. [7][8][9][10] A possible complication of such devices is the intraprocedural or delayed fracture of the spinous process and/or laminae adjacent to the device. 6,11 Consequently, this treatment is contraindicated in patients with osteoporosis.…”