Lumbar spinal stenosis treatment with aperius perclid interspinous system

Abstract

PurposeThe purpose of this study is to report clinical outcome and imaging changes of percutaneous Aperius stand-alone implant in patients with degenerative lumbar spinal stenosis and neurogenic intermittent claudication, which did not respond to conservative treatment.MethodBetween January 2008 and July 2010, 37 patients (20 males and 17 females) with mean age of 64.3 years underwent surgery for the onset of claudicatio spinalis with Aperius PercLID interspinous device (Medtronic). In all patients, the diagnosis was: foraminal stenosis, in one case (2.7 %) it was associated to a degenerative anterior listhesis (I grade), in three cases (8.1 %) it was associated to an intraforaminal disc herniation. The mean follow-up was of 18 months (range 2–35 months). The patients were evaluated through the Oswestry disability index, Zurich Claudication Questionnaire (ZCQ), VAS scales. In all cases were obtained preoperative and in postoperative radiographs and magnetic resonance imaging.ResultsThe VAS score decreased significantly after surgery: the patients presented a mean VAS of seven preoperatively and two postoperatively (p < 0.001).The ZCQ score significantly decreased postoperatively, with an average reduction of 21.89 % (p < 0.001).The ODI score as well showed a significant reduction postoperatively of an average 26.09 % (p < 0.001).ConclusionDespite of the brief follow up, the preliminary results are encouraging, showing a significantly decrease of the disability parameters, a marked improvement of the function with the vanishing of the claudicatio spinalis and the following increase of the free interval during the walk. Aperius PercLID system seems to offer an alternative to the traditional decompression surgery.

Midterm Clinical and Radiologic Outcomes after Percutaneous Interspinous Spacer Treatment for Neurogenic Intermittent Claudication

“…Another study reported durable reductions in VAS score and quality-of-life measures to 12 months (16); similar reductions in VAS and ODI scores were reported in a smaller retrospectively studied cohort of 37 patients at mean 18-month follow-up (17). Our study adds to the existing literature by providing data for durable reduction in VAS and ODI scores in a cohort of Note-Data are presented as number (%) or mean Ϯ SD.…”

Cementless Primary Total Hip Arthroplasty with a Trabecular Titanium Implant: Results at Short-to-Medium-Term Follow-Up

“…If clinical examination is uncertain, a magnetic resonance imaging should be obtained and minimally invasive procedures could eventually be performed. 19 Moreover, the study from Naziri et al reported excellent survival rates in a similar to the present population, but Carli et al described some concern for early Tritanium cup loosening. Our survivorship rate was comparably excellent and up to now the alarm for early mobilization of the cup cannot be seen: the only prematurely loose cup was due to its primary undersizing that probably never achieved optimal fixation and osseointegration.…”

Axial loading during MRI reveals insufficient effect of percutaneous interspinous implants (Aperius™ PerCLID™) on spinal canal area

“…Postoperatively, IPDs have shown good short-time clinical effects, but the long-term results have been less clear and a high reoperation rate compared to ODS has been reported [9][10][11]. In contradiction to the lack of long-term improvement in subjective symptoms and high reoperation rates, some studies have shown beneficial radiological effects [12][13][14].…”

“…Not many studies have been published on the radiological effects of IPDs, either by conventional MRI or with the spine in a loaded position, such as upright MRI or axial loading during MRI (alMRI). A few studies have reported a small but statistically significant increase regarding the dural sac and spinal canal cross-sectional area after IPD insertion [12,15,16], even up to 2 years postoperatively. However, these studies all lack a control group and do not provide any information regarding the effect on adjacent levels.…”