The Interspinous Spacer: A New Posterior Dynamic Stabilization Concept for Prevention of Adjacent Segment Disease

Abstract

Introduction. Posterior Dynamic stabilization using the interspinous spacer device is a known to be used as an alternative to rigid fusion in neurogenic claudication patients in the absence of macro instability. Actually, it plays an important in the management of adjacent segment disease in previously fused lumbar spine. Materials and Method. We report our experience with posterior dynamic stabilization using an interspinous spacer. 134 cases performed in our institution between September 2008 and August 2012 with different lumbar spine pathologies. The ages of our patients were between 40 and 72 years, with a mean age of 57 years. After almost 4 years of follow up in our patient and comparing their outcome to our previous serious we found that in some case the interspinous distracter has an important role not only in the treatment of adjacent segment disease but also in its prevention. Results and Discussion. Clinical improvement was noted in ISD-treated patients, with high satisfaction rate. At first, radicular pain improves with more than 3/10 reduction of the mean score on visual analog scale (VAS). In addition, disability score as well as disc height and lordotic angle showed major improvement at 3 to 6 months post operatively. And, no adjacent segment disease was reported in the patient operated with interspinous spacer. Conclusion. The interspinous spacer is safe and efficient modality to be used not only as a treatment of adjacent segment disease but also as a preventive measure in patients necessitating rigid fusion.

K-rod dynamic internal fixation versus microendoscopic discectomy for the treatment of single-segment lumbar disc herniation

“…16,17 Dynamic stabilization system without fusion, which allows ideal mobility of the vertebra, can reduce the loading on the intervertebral disc and thus improve spinal stability and reduce adjacent segment degeneration. 13,18 In this study, we found that K-rod internal fixation reduced adjacent segment degeneration. The elastic PEEK rod used in this study has an elastic modulus of about 5 GPa, which is more similar to that of the cortical bone (12 GPa) than titanium alloy (110 GPa).…”

“…12 Dynamic stabilization system has been found to decrease adjacent segment degeneration, reduce the loading on the intervertebral disc and improve spinal stability. 13 The K-rod system is one type of the dynamic stabilization devices, which is designed to maintain natural motion of the vertebrae and thus prevent adjacent segment degeneration. The K-rod system has been used for the treatment of lumbar disc herniation with satisfactory outcomes.…”

Effect of Coflex interspinous stabilization on the prevention of progression of adjacent segment degeneration after single level and skipped level spinal fusion in a canine model

“…to tackle with ASD, because it can facilitate to decelerate the degenerative process by providing intervertebral dynamic stability for adjacent segment [6]. Coflex is a dynamic ISP, it is a U-shaped, compressible device which can be implanted between the spinous processes after decompression [8].…”

Aseptic intrafascial and extrafascial abscesses 10 years after a 2-level DIAM insertion procedure

“…Some authors do not describe the cases of infection as a delayed complication following DIAM procedures within the follow-up period from 1 to 4 years, whereas others report the occurrence of infection in the follow-up period from 1 to 4 years in less than 2% of the patients with implanted interspinous spacers. 10,12,18 So far, there have not been published studies reporting infective or other complications 10 or more years after the placement of DIAM implants and there are no data related to delayed, simultaneous intolerance occurring in the same patient and at all treated levels. The aim of this report is to present a case of an extremely late complication (after 10 years) in the form of intra-and extrafascial dumbbell abscesses, simultaneously appearing at both levels treated with the DIAM procedure.…”