Clinical analysis following lumbar interspinous devices implant: where we are and where we go

Grasso, Giovanni; Giambartino, Filippo; Iacopino, Domenico Gerardo

doi:10.1038/sc.2014.100

Cited by 8 publications

(5 citation statements)

References 22 publications

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“…Although the rationale for surgery is often unclear, and despite the lack of convincing evidence regarding the effectiveness of surgery in the treatment of symptomatic DDD, the number of surgical procedures performed is continually increasing [2,3]. Yet the presence of LBP and DDD can support the placement of an interspinous device (ISD) [4][5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

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

Co-Minh¹

2021

IJCCR

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Background: Lumbar degenerative disc disease is one of the most common conditions associated with chronic low back pain. IntraSPINE® is a novel inter-laminar device that allows more physiological rocking-type movements in flexion and extension. Aim: To evaluate the results of patients with symptomatic Lumbar degenerative disc disease treated with an IntraSPINE® device and followed up over a 3-year period. Materials and Methods: A Prospective longitudinal research study involving patients with imaging-confirmed Lumbar degenerative disc disease in whom conservative treatment was unsuccessful. Outcome measures were changes over baseline score on the Oswestry Disability Index (ODI), and low back and radicular pain assessed at 6, 12, 24 and 36 months postoperatively. Overall success, a composite outcome that included key safety and clinical considerations, was assessed. Secondary outcomes included satisfaction with symptoms, employment status and post-surgery medical interventions. To compare differences in longitudinal clinical score patterns over 36 months, a mixed-effect model ANCOVA with repeated measurements was performed, with adjustment for low back and radicular pain score and ODI score at baseline. Results: 231 patients were recruited and 180 completed the study. A significant improvement in ODI score (p=0.0597), as well as in VAS (Visual Analogue Scale) scores for back (p= 0.0228) and leg pain (p<0.0001) was observed during the follow-up. For ODI score, the mean percentage decrease from inclusion to month 36 was 64.5%. These scores were respectively 66.2% for radicular pain and 46.4% for low back pain. In 73% of cases, surgery was considered successful. 89% of working patients returned to work and 68% of patients were very satisfied at month 12. Only four patients presented intraoperative complications.

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Section: Introductionmentioning

confidence: 99%

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

Co-Minh¹

2021

IJCCR

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“…[1012] Over the years, a variety of minimally invasive techniques have been investigated as treatment of low back pain related to disc disease. [13] Techniques can be broadly divided into techniques that are designed to remove or ablate disc material, and thus decompress the disc, and those designed to alter the biomechanics of the disc annulus. All these procedures are performed percutaneously with variable results.…”

Section: Introductionmentioning

confidence: 99%

Prevention of lumbar reherniation by the intraoperative use of a radiofrequency bipolar device: A case–control study

Grasso

Torregrossa

Landi

2019

J Craniovert Jun Spine

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Objective: The most common complication after lumbar discectomy is reherniation. Although many studies have investigated factors that may increase the reherniation risk, few are agreed upon all. It has been suggested that limited nucleus removal is associated with higher reherniation risk, while more aggressive nucleus removal can result in increased disc degeneration. Here, we assessed the efficacy of a coblation-assisted microdiscectomy in adult patients undergoing single-level disc surgery. Methods: We prospectively compared the reherniation rate in 75 patients (Group 1) undergoing single-level lumbar disc surgery completed with the radiofrequency bipolar system Aquamantys ® (Medtronic, Minneapolis, MN, USA) to that of a historical control group ( n = 75) matched for variables related to herniation level and characteristics (Group 2). Patients were followed up to 4 years. Reherniations were assessed, pain and function were monitored throughout, and imaging was performed at annual follow-up. Results: The overall symptomatic reherniation rate was 4%. In particular, one case (1.3%) was observed in Group 1 and five (6.7%) in Group 2 ( P < 0.05). Magnetic resonance imaging identified a total of 4 (2.7%) asymptomatic reherniations at 12 months, 6 (4%) at 24 and 36 months, and 7 (4.7%) at 48 months. Overall, Group 1 contained one (1.3%) asymptomatic reherniation case, while six (8%) were observed in Group 2 ( P < 0.05). Conclusions: The low reherniation rate in patients treated by the coblation-assisted microdiscectomy suggests that this technique may reduce the reherniation risk. Clinical outcomes for pain and function at 4 years follow-up compared favorably with literature data. Randomized controlled trial could confirm these results.

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“…Moreover, ASD causes long-term dissatisfaction after spine fusion in 20–40% of patients. It can be difficult to treat ASD with surgery due to previous lumbar fusion [ 1 , 4 , 7 ]; therefore, current research is focused on preventing the disease and delaying its progression [ 8 , 9 ]. Interspinous dynamic fixation provides a new method for preventing ASD after lumbar interbody fusion.…”

Section: Introductionmentioning

confidence: 99%

Single-Level Rigid Fixation Combined with Coflex: A Biomechanical Study

Che

Chen

et al. 2016

Med Sci Monit

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BackgroundThe purpose of this biomechanical in vitro study was to compare the kinematics and intradiscal pressure achieved with 2 methods: L4–L5 pedicle screw-rod fixation (PSRF) with an upper L3–L4 Coflex device and L4–L5 PSRF alone. The results were used to characterize the biomechanics of the topping-off operation with a Coflex device for the lumbar motion segment adjacent to single-level rigid fixation.Material/MethodsSix human cadaveric spine specimens were biomechanically tested in vitro (6 males, 0 females). The 3-dimensional specimen motion in response to applied loads during flexibility tests was determined. Loads were applied along anatomic axes to induce flexion-extension, lateral bending, and axial rotation. All specimens were first studied with intact lumbar motion segments, then with L4–L5 PSRF alone, and finally with L4–L5 PSRF with an upper L3–L4 Coflex device. A non-paired comparison of the 3 configurations under 3 different conditions was made.ResultsPSRF, with or without a Coflex device, significantly increased the range of motion (ROM) in the upper adjacent motion segments in all directions of loading. The intradiscal pressure (IDP) changed slightly. A correlation analysis showed that the ROM and IDP are significantly positively correlated. The application of the upper motion segment of the Coflex device provided greater stability in all directions of motion than did PSRF alone, particularly for extension (p<0.05), while use of a Coflex device did not significantly decrease the IDP compared with PSRF alone (p>0.05).ConclusionsThese results suggest that L4–L5 PSRF with an L3–L4 Coflex device is more stable than L4–L5 PSRF alone. PSRF with an upper Coflex device is a promising alternative to PSRF alone. Based on these biomechanical tests, it might be considered a protective method to prevent adjacent segment degeneration (ASD), although some limitations with this in vitro study must be addressed in the future.

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Clinical analysis following lumbar interspinous devices implant: where we are and where we go

Abstract: lumbar interspinous device

Cited by 8 publications

References 22 publications

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

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

Prevention of lumbar reherniation by the intraoperative use of a radiofrequency bipolar device: A case–control study

Single-Level Rigid Fixation Combined with Coflex: A Biomechanical Study

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