Dynamic Intraspinous Stabilization reduces Spinal Mobility After Bilateral Laminotomy

Abstract

Dynamic stabilization devices were developed to reduce spinal hypermobility while preserving a certain degree of physiological motion. Our goal was to assess radiographic and clinical outcomes of patients treated with surgical decompression and stabilization with the Limiflex TM implant.We investigated the effect of LimiFlex TM implantation on post-operative translation and angulation in 36 patients with spinal stenosis and degenerative spondylolisthesis Meyerding Grade I treated with decompression and dynamic stabilization.Significant improvements following lumbar decompression were observed. The average Oswestry Disability Index (ODI) score fell from 45.9 Pre-operatively to 29.6 at dismissal and 26.5 at first follow up. The average visual analog scale (VAS) score fell from 7 Pre-operatively to 3 at dismissal and 3 at follow up. Pre-operatively the median translation within the operated segment was 2.0 mm. Post-operatively the translation was reduced to 0.7 mm (p=0.006, Student's t-test). Pre-operatively the median rotation within the operated segment was 4.6°. Post-operatively the rotation was reduced to 3.5° (p=0.08, Student's t-test). The re-operation rate was 6 out of 36 (16.7 %).Here we provide evidence suggesting that the dynamic paraspinous stabilization implant Limiflex TM is well tolerated in patients with degenerative spondylolisthesis and lumbar spinal canal stenosis. Our data show that within 3 months after the operation it limits hypermobility in the operated segment. This might be well suited in cases such as spinal stenosis with Grade I degenerative spondylolisthesis, where instability at the operated segment is likely to happen, but a patient is not indicated for a spinal fusion.