Heterotopic Ossification in Vertebral Interlaminar/Interspinous Instrumentation: Report of a Case

Maida, Giuseppe; Marcati, Eleonora; Sarubbo, Silvio

doi:10.1155/2012/970642

Cited by 16 publications

(14 citation statements)

References 40 publications

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“…In the case described by Maida et al, neural structures were compressed by heterotopic bone, resulting in the recurrence of spinal stenosis symptoms. 23 Theoretically, interspinous ossification is not necessarily bad because it could enhance stabilization at the treated level.…”

Section: Discussionmentioning

confidence: 99%

Failure rates and complications of interspinous process decompression devices: a European multicenter study

Gazzeri

Galarza

Neroni

et al. 2015

FOC

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OBJECT Spacers placed between the lumbar spinous processes represent a promising surgical treatment alternative for a variety of spinal pathologies. They provide an unloading distractive force to the stenotic motion segment, restoring foraminal height, and have the potential to relieve symptoms of degenerative disc disease. The authors performed a retrospective, multicenter nonrandomized study consisting of 1108 patients to evaluate implant survival and failure modes after the implantation of 8 different interspinous process devices (IPDs). METHODS The medical records of patients who had undergone placement of an IPD were retrospectively evaluated, and demographic information, diagnosis, and preoperative pain levels were recorded. Preoperative and postoperative clinical assessments in the patients were based on the visual analog scale. A minimum of 3 years after IPD placement, information on long-term outcomes was obtained from additional follow-up or from patient medical and radiological records. RESULTS One thousand one hundred eight patients affected by symptomatic 1- or 2-level segmental lumbar spine degenerative disease underwent placement of an IPD. The complication rate was 7.8%. There were 27 fractures of the spinous process and 23 dura mater tears with CSF leakage. The ultimate failure rate requiring additional surgery was 9.6%. The reasons for revision, which always involved removal of the original implant, were acute worsening of low-back pain or lack of improvement (45 cases), recurrence of symptoms after an initial good outcome (42 cases), and implant dislocation (20 cases). CONCLUSIONS The IPD is not a substitute for a more invasive 3-column fusion procedure in cases of major instability and spondylolisthesis. Overdistraction, poor bone density, and poor patient selection may all be factors in the development of complications. Preoperatively, careful attention should be paid to bone density, appropriate implant size, and optimal patient selection.

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Section: Discussionmentioning

confidence: 99%

Failure rates and complications of interspinous process decompression devices: a European multicenter study

Gazzeri

Galarza

Neroni

et al. 2015

FOC

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“…Large osteophytes could intrude into the spinal canal, which might injure the neural structure. In a case report by Maida et al, 11 the dural sac was compressed by the heterotopic bone, which resulted in recurrent symptoms of lumbar stenosis. However, such an outcome is very rare; only 1 case has been reported.…”

Section: 1517mentioning

confidence: 99%

“…4 Another effect, such as HO, might be found at a long-term follow- up visit. 11 The clinical significance of HO after placement of ISP devices is unclear. Large osteophytes could intrude into the spinal canal, which might injure the neural structure.…”

Section: 1517mentioning

confidence: 99%

“…Miller et al 13 noted the phenomenon of reactive osteophytes growing bilaterally along the interface of the spinous process and X-STOP device in a revision surgery. Maida et al 11 reported the first case of HO after implantation of a Coflex device; the patient had undergone a revision surgery for recurrence of neurogenic claudication caused by abnormal ossification. 11 In this study, we aimed to investigate the prevalence of HO after placement of Coflex ISP devices (Paradigm Spine) and to evaluate possible risk factors associated with the occurrence of HO.…”

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confidence: 99%

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Incidence of heterotopic ossification after implantation of interspinous process devices

Tian¹,

Wu²,

et al. 2013

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Object This study aimed to investigate the incidence rate of heterotopic ossification (HO) after implantation of Coflex interspinous devices. Possible risk factors associated with HO were evaluated. Methods The authors retrospectively analyzed patients who had undergone single-level (L4–5) implantation of a Coflex device for the treatment of lumbar spinal stenosis. Patient data recorded were age, sex, height, weight, body mass index, smoking habits, and surgical time. Heterotopic ossification was identified through lumbar anteroposterior and lateral view radiographs. The authors developed a simple classification for defining HO and compared HO-positive and HO-negative cases to identify possible risk factors. Results Among 32 patients with follow-up times of 24–57 months, HO was detectable in 26 (81.2%). Among these 26 patients, HO was in the lateral space of the spinous process but not in the interspinous space in 8, HO was in the interspinous space but did not bridge the adjacent spinous process in 16, and interspinous fusion occurred at the level of the device in 2. Occurrence of HO was not associated with patient age, sex, height, weight, body mass index, smoking habits, or surgical time. Conclusions A high incidence of HO has been detected after implantation of Coflex devices. Clinicians should be aware of this possible outcome, and more studies should be conducted to clarify the clinical effects of HO.

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“…Interspinous Posterior Device (IPD) is a term used to identify a relatively recent group of implants used to treat lumbar spine stenosis with the presumed aim of a dynamic motion control systems [1][2][3][4]. All of IPD are small devices implanted between the vertebral spinous processes [5][6][7][8][9][10][11]. After implantation, the device must be opened or expanded to distract (open) the neural foramen and decompress the roots [5][6][7].…”

mentioning

confidence: 99%

Interspinous Posterior Devices IPD: A Miracle Cure for the Lumbar Spinal Stenosis?

Aless¹,

L²,

Delfini³

2014

Surgery Curr Res

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Heterotopic Ossification in Vertebral Interlaminar/Interspinous Instrumentation: Report of a Case

Cited by 16 publications

References 40 publications

Failure rates and complications of interspinous process decompression devices: a European multicenter study

Failure rates and complications of interspinous process decompression devices: a European multicenter study

Incidence of heterotopic ossification after implantation of interspinous process devices

Interspinous Posterior Devices IPD: A Miracle Cure for the Lumbar Spinal Stenosis?

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