Elastic stabilization alone or combined with rigid fusion in spinal surgery: a biomechanical study and clinical experience based on 82 cases

Caserta, Salvatore; Maida, Giovanni Andrea La; Misaggi, Bernardo; Peroni, D.; Pietrabissa, Riccardo; Raimondi, Manuela Teresa; Redaelli, Andrea

doi:10.1007/s00586-002-0426-6

Cited by 56 publications

(26 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This is in accordance with previous reports showing that IPDs do not alter the loading at the adjacent segments 15,18,19,21–25. Even in the four patients with no preoperative segmental flexion/extension mobility, and the three cases who lost normal mobility after surgery, radiographic changes of adjacent segment degeneration were not observed.…”

Section: Discussionsupporting

confidence: 93%

Clinical outcome following DIAM implantation for symptomatic lumbar internal disk disruption: a 3-year retrospective analysis

Lu¹,

Liliang²,

Wang³

et al. 2016

JPR

View full text Add to dashboard Cite

Background/objectiveInternal disk disruption (IDD), an early event of lumbar disk degeneration, is the most common cause of low back pain. Since increased intradiskal pressure (IDP) is associated with symptoms and progression of disk degeneration, unloading a painful disk with an interspinous process device (IPD) is a rational treatment option. The goal of this study was to evaluate the effectiveness of dynamic stabilization with an IPD in the treatment of symptomatic IDD of the lumbar spine.Patients and methodsPatients with symptomatic IDD were treated with implantation of an IPD, the device for intervertebral assisted motion (DIAM). Diagnosis of IDD was based on typical MRI finding of posterior annular high-intensity zone and positive provocative test on discography. IDP was analyzed intraoperatively. Axial back and leg pain was evaluated with visual analog scale, functional status with Oswestry Disability Index, and final clinical outcomes with Odom criteria. Data from 34 patients followed up for at least 3 years were collected.ResultsDIAM implantation significantly reduced IDP (n=11, P<0.0001). All 34 patients reported symptom relief. Thirty-one patients (91%) remained symptom free until the last followups. Three patients (9%) experienced recurrence of pain, of which the causes were unrelated to the IDD or surgery. Disk status at the DIAM-implanted segments remained stable. Segmental flexion/extension mobility was preserved in 27 of 30 patients with preoperative mobility. No proximal or distal adjacent segment degeneration was observed. The final clinical outcomes were excellent/good in 31 and fair/poor in three patients.ConclusionFor patients with symptomatic IDD, dynamic stabilization with DIAM provides pain relief and functional improvement. The implantation maintains disk status and prevents progression of disk degeneration, without compromising segmental flexion/extension mobility or causing adjacent segment degeneration.

show abstract

Section: Discussionsupporting

confidence: 93%

Clinical outcome following DIAM implantation for symptomatic lumbar internal disk disruption: a 3-year retrospective analysis

Lu¹,

Liliang²,

Wang³

et al. 2016

JPR

View full text Add to dashboard Cite

show abstract

“…Caserta et al [13] found that the transverse sectional area of the vertebral canal and lateral neural foramen can be increased at flexion but decreased at extension. Joshua et al [14] found that the stenosis of the vertebral canal and lateral neural foramen during extension can be stopped by using an IPD while the vertebral canal and lateral neural foramen of the nearby segments remain unaffected.…”

Section: Introductionmentioning

confidence: 99%

The effects of a new shape-memory alloy interspinous process device on the distribution of intervertebral disc pressures in vitro

Zheng

Yao

Cheng

et al. 2010

Journal of Biomedical Research

View full text Add to dashboard Cite

This study was designed to measure the pressure distribution of the intervertebral disc under different degrees of distraction of the interspinous process, because of a suspicion that the degree of distraction of the spinous process may have a close relationship with the disc load share. Six human cadaver lumbar spine L2-L5 segments were loaded in flexion, neutral position, and extension. The L3-L4 disc load was measured at each position using pressure measuring films. Shape-memory interspinous process implants (SMID) with different spacer heights, ranging in size from 10 to 20 mm at 2 mm increments, were used. It was found that a SMID with a spacer height equal to the distance of the interspinous process in the neutral position can share the biomechanical disc load without a significant change of load in the anterior annulus. An interspinous process stabilizing device (IPD) would not be appropriate to use in those cases with serious spinal stenosis because the over-distraction of the interspinous process by the SMID would lead to overloading the anterior annulus which is a recognized cause of disc degeneration.

show abstract

“…На протяжении последнего десятилетия в лечении дегенеративных поражений поясничного отдела позвоночника достигнуты значительные успехи, связанные с развитием современных методов нейровизуализации позвоночника и внедрением в хирургическую практику целого спектра имплантируемых систем стабилизации позвоночника [1,2,3]. Реконструктивно-стабилизирующие хирургические вмешательства при дискогенных компрессионных формах пояснично-крестцового радикулита не утрачивают своей актуальности в современной нейроортопедии [1,4,5].…”

Section: актуальностьunclassified

“…Проведённый анализ литературных данных отечественных и зарубежных авторов показал, что стабилизация поражённого позвоночно-двигательного сегмента (ПДС) является важнейшим компонентом патогенетически обоснованного хирургического лечения дегенеративных форм патологии позвоночника [2,9].…”

Section: актуальностьunclassified

The Experience of Using the Implantable Interspinous System COFLEX in the Surgical Treatment of Compression Forms of Lumbosacral Radiculitis

Потапов

Кошкарёва

Животенко

et al. 2019

Acta biomedica scientifica

View full text Add to dashboard Cite

Резюме В работе представлен опыт хирургического лечения 58 пациентов с дискогенным пояснично-крестцовым радикулитом. Целью хирургического лечения было устранение компрессии спинномозговых корешков грыжей диска с последующей стабилизацией позвоночно-двигательного сегмента имплантируемой межостистой динамической системой COFLEX фирмы «Paradigm Spine». Показаниями к хирургическому лечению были стойкий корешковый болевой синдром, некупируемый консервативными методами лечения, и диско-радикулярный конфликт в зоне заинтересованного позвоночно-двигательного сегмента, подтвержденный лучевыми методами исследования. В диагностике были использованы методы исследования: клинико-неврологический осмотр, обзорная и функциональная спондилография поясничного отдела позвоночника, компьютерная томография с контрастной миелографией, морфометрический и статистические методы исследования. Эффективность лечения оценена у 49 пациентов (84 % оперированных) через полтора года после операции. У всех пациентов отмечен полный регресс неврологического дефицита и удовлетворительное стояние имплантированной межостистой динамической системы COFLEX в оперированном позвоночно-двигательном сегменте. Таким образом, использование имплантируемой динамической системы COFLEX при выше указанных показаниях является для оперирующих хирургов методом выбора, при котором предполагается сохранение функции заинтересованного позвоночно-двигательного сегмента.

show abstract

Elastic stabilization alone or combined with rigid fusion in spinal surgery: a biomechanical study and clinical experience based on 82 cases

Cited by 56 publications

References 6 publications

Clinical outcome following DIAM implantation for symptomatic lumbar internal disk disruption: a 3-year retrospective analysis

Clinical outcome following DIAM implantation for symptomatic lumbar internal disk disruption: a 3-year retrospective analysis

The effects of a new shape-memory alloy interspinous process device on the distribution of intervertebral disc pressures in vitro

The Experience of Using the Implantable Interspinous System COFLEX in the Surgical Treatment of Compression Forms of Lumbosacral Radiculitis

Contact Info

Product

Resources

About