A Systematic Review of Interspinous Dynamic Stabilization

Abstract

BackgroundA systematic literature review of interspinous dynamic stabilization, including DIAM, Wallis, Coflex, and X-STOP, was conducted to assess its safety and efficacy.MethodsThe search was done in Korean and English, by using eight domestic databases which included KoreaMed and international databases, such as Ovid Medline, Embase, and the Cochrane Library. A total of 306 articles were identified, but the animal studies, preclinical studies, and studies that reported the same results were excluded. As a result, a total of 286 articles were excluded and the remaining 20 were included in the final assessment. Two assessors independently extracted data from these articles using predetermined selection criteria. Qualities of the articles included were assessed using Scottish Intercollegiate Guidelines Network (SIGN).ResultsThe complication rate of interspinous dynamic stabilization has been reported to be 0% to 32.3% in 3- to 41-month follow-up studies. The complication rate of combined interspinous dynamic stabilization and decompression treatment (32.3%) was greater than that of decompression alone (6.5%), but no complication that significantly affected treatment results was found. Interspinous dynamic stabilization produced slightly better clinical outcomes than conservative treatments for spinal stenosis. Good outcomes were also obtained in single-group studies. No significant difference in treatment outcomes was found, and the studies compared interspinous dynamic stabilization with decompression or fusion alone.ConclusionsNo particular problem was found regarding the safety of the technique. Its clinical outcomes were similar to those of conventional techniques, and no additional clinical advantage could be attributed to interspinous dynamic stabilization. However, few studies have been conducted on the long-term efficacy of interspinous dynamic stabilization. Thus, the authors suggest further clinical studies be conducted to validate the theoretical advantages and clinical efficacy of this technique.

Surgical outcomes of patients with degenerative lumbar disc disease post-IntraSPINE® device fixation: Three-year prospective study

“…Our study found that complications related to surgery or to the device were very few, with only four patients presenting intraoperative complications (spinal fluid leak) which were unrelated to specific use of IntraSPINE ® . This is consistent with the results of Leeet al who reported no complications such as myocardial infarction, pulmonary embolism, cerebrovascular accident, acute renal failure, mortality, deep venous thrombosis, ileus or urinary tract infection [20].…”

Length of stay, costs, and complications in lumbar disc herniation surgery by standard PLIF versus a new dynamic interspinous stabilization technique

“…The most frequent complications were implant related complications in both groups. On the one hand, studies on IDSS,such as Diam, Wallis, and Coflex; reported an implant related complication rate up to 32.3% [ 32 ]. On the other hand, Gelais et al in a systematic review, reported that rates of screw malposition in fusion surgery, vary considerably, they found the percentage of screws fully contained in the pedicle ranged from 28 to 85% [ 28 ].…”

Spine Products in Use Both Outside and Inside the United States

“…These procedures have been proposed as minimally invasive alternative procedures to laminectomy and fusion (Landi 2014). By distracting the adjacent spinous processes and/or lamina and thereby restricting extension in patients with lumbar spinal stenosis and neurogenic claudication, these interspinous distractor devices can alleviate symptoms that arise from neural compression (Lee et al 2015). These devices enlarge the neural foramen, decompress the causa equina, and act as spacers between the spinous processes to limit extension of the spinal interspace.…”

“…Because of the minimally invasive nature of placement of these devices, proponents argue that such techniques lead to shorter hospital stay, preservation of local bone and tissue, reduced risk of cerebrospinal fluid leakage, and is reversible in such a way that it does not limit future treatment options. Some potential complications of these spacer devices are fracturing of spinous processes, incorrect positioning, and mechanical failure of the devices (Lee et al 2015).…”