One-year Outcome Evaluation after Interspinous Implantation for Degenerative Spinal Stenosis with Segmental Instability

Abstract

The authors hypothesized that the placement of the interspinous implant would show a similar clinical outcome to the posterior lumbar interbody fusion (PLIF) in patients having spinal stenosis with mild segmental instability and that this method would be superior to PLIF without significantly affecting degeneration at the adjacent segments. Forty two adult patients having degenerative spinal stenosis with mild segmental instabilit who underwent implantation of Coflex™ (Spine motion, Germany) or PLIF at L4-5 between January 2000 and December 2003 were consecutively selected and studied for one-year clinical outcome. At 12 months after surgery, both groups showed a significant improvement in the visual analogue scale score and Oswestry disability index score for both lower extremity pain and low back pain. However, the range of motion at the upper adjacent segments (L3-4) increased significantly after surgery in the PLIF group, which was not manifested in the Coflex™ group during the follow-up. The authors assumed that interspinous implantation can be an alternative treatment for the spinal stenosis with segmental instability in selected conditions posing less stress on the superior adjacent level than PLIF.

Does an interspinous device (Coflex™) improve the outcome of decompressive surgery in lumbar spinal stenosis? One-year follow up of a prospective case control study of 60 patients

“…The authors followed that the additional implantation of the Coflex TM device is safe, simple and gives good and excellent results in decompressive surgery of LSS. Kong et al [13] made a comparison analysis between decompression with concomitant surgical placement of a Coflex TM Device and PLIFinstrumentation and found at 1-year follow up a comparable clinical outcome in the VAS and Oswestry score.…”

Minimum 2-Year Follow-Up Result of Degenerative Spinal Stenosis Treated with Interspinous U (CoflexTM

“…However, no long term effect of ISU in restoration of disc and foraminal height has been proved 2,25) . As there is no report longer than two years for ISU, the longer term clinical and radiological role and problems of the device are still remained unknown 8,9,25) . The aim of this study was to evaluate minimum two-year follow up result of ISU in degenerative spinal stenosis in comparison to posterior lumbar interbody fusion (PLIF).…”

Effect of a novel interspinous implant on lumbar spinal range of motion

“…Interspinous implants are also thought to decrease intra-discal pressure [34], unload the facet joints [39], restore foraminal height [12], and provide improved spinal stability (especially in extension) [13,36], and offer the advantage of being minimally invasive. Several such implants have been developed, some connecting spinous processes and laminae [18], others placed between two adjacent spinous processes with a spring [17], one with a silicone implant [22], another with a U-shaped device [16], and another called the X-Stop Interspinous Process Distraction System [30,40]. A different type of implant for non-rigid stabilization of lumbar segments uses polyetheretherketone (PEEK), an interspinous blocker fixed to the spine by two bands looped and tensioned around the adjacent spinous processes, termed the Wallis system [29].…”