Percutaneous interspinous distraction device for the treatment of lumbar spinal canal stenosis: Clinical and radiographic results at 2-year follow-up

Abstract

ObjectiveTo evaluate the effectiveness of the In- space (Synthes, Umkirch, Germany) and the correlation between radiographic parameters and clinical outcome in patients with lumbar spinal canal stenosis (LSS).MethodsBetween June 2009 and May 2013, 56 patients with LSS underwent In-space by one senior surgeon. All of the patients were evaluated both clinically and radiographic measurements before the procedure and each visit at the postoperative follow-up. Preoperative and postoperative X-ray imaging was performed before the procedure and at follow-up to assess the correlation with the clinical outcome. Radiological measurements and clinical outcomes were recorded to establish a relationship between the radiographic parameters and clinical outcome of this procedure. All patients had at least 2 years of follow-up.ResultsThe mean VAS score of back pain decreased significantly (p < 0.05).ConclusionsOur data suggest that percutaneous interspinous devices are a good alternative to treat LSS. The device offers significant decrease in back pain, leg pain and ODI score with 2-year lasting relief from symptoms. The increased intervertebral foramenal space explains the improvement of leg pain, but the mechanism of back pain relief remains unclear. A very weak correlation between the radiographic changes and improvement of pain was found.

Development and validation of a novel nomogram to predict the risk of the prolonged postoperative length of stay for lumbar spinal stenosis patients

“…Epidural fibrosis, sacroiliac joint pain, disc herniation, facet joint pain, and improper surgery have all been proposed as secondary reasons for the unrelenting pain and incapacity in the low back and lower limbs after lumbar spine surgery [26] However, in our results, the pain degree which is quantified by visual analogue scales (VAS) first and categorized is not related to prolonged PLOS. Yet, the mechanism behind lower back pain is still needed to be explored [27][28][29]. The mean age is significantly different between the two groups, which is in line with previous studies [30,31].…”

Interspinous implants: are the new implants better than the last generation? A review

“…Yingsakmongkol et al found that VAS scores for back pain and leg pain decreased from 6.56 to 2.64 at 1 week postoperatively [27]. Over the subsequent 2 years, patients experienced no significant worsening in VAS for back or leg pain.…”

“…Other studies have reported the maintenance of initially improved VAS up to 2 years [21, 27, 36•, 38] or even 3 years [13,23]. Of the latter studies, three are with next-generation products [23,27,38] and three correspond to last-generation [13,21,36•] IPDs. In the preparation of this manuscript, the authors could only find two RCTs in the literature comparing the success of pain reduction between next-vs. last-generation IPDs [23,33].…”