Evaluation of Interspinous DynamicStabilization in Lumbar CanalStenosis
Abou Bakr Gamal Ramadan;
Abstract
Background:
Lumbar spinal stenosis is an increasingly common diag- nosis in elderly individuals and the rates of surgery have risen all over the world.
In long- term outcomes, surgically treated patients reported greater improvement in leg symptoms and back-related functional status than non-surgically treated patients.
Lumbar instability may result from extensive decompressive procedures and might lead to poor outcome. For those reasons and with the introduction of lumbar pedicle screws and cages lumbar fusions with instrumentations became a common procedure after laminectomy and decompression for lumbar spine stenosis.However, it is also known that there is a higher rate of complications in instrumented fusions in the elderly patients, such as pseudoarthrosis, adjacent segment disease, implant failure due to loosening and complications of related to the co-morbidity of such patients. For these reasons there was a need for less invasive strategies that provide a balance between safety and effectiveness.
A number of interspinous process devices have been recently introduced to the lumbar spinal market as an alternative to conventional surgical procedures in the treatment of symptomatic lumbar stenosis. The aim of implanting these interspinous devices is to unload the facet joints, restore foraminal height and provide spinal stability in order to improve the clinical outcome of surgery and increasing the cross sectional area of the lumbar canal by causing flexion in the implanted segment.
Objective:
The purpose of our prospective study is to evaluate the surgical outcome of the interspinous spacers versusdecompressive laminectomy in the management degenerative lumbar canal stenosis.
Methods:
This prospective comparative study includes two groups of patients that were operated upon in Ain Shams University hospitals and other hospital in the period between January 2010 to December 2013. In Group one (ISP) we treated 28 patients by implanting interspinous spacer (Coflex or X-Stop), group 2 (DL)25 patients were treated with decompressive laminectomy. Pre-and postoperative disability and pain scores were measured using the Oswestry disability index and visual analogue score.
The selection of surgical approach was according to the surgeon preference.
Results: Our statistical results revealed that there was no statistically significant difference in the outcome between the two groups regarding VAS for leg pain nor the ODI, however the improvement of back pain was better in the(DL) group.
The complications and reoperation rates was higher in the (ISP) group.
Lumbar spinal stenosis is an increasingly common diag- nosis in elderly individuals and the rates of surgery have risen all over the world.
In long- term outcomes, surgically treated patients reported greater improvement in leg symptoms and back-related functional status than non-surgically treated patients.
Lumbar instability may result from extensive decompressive procedures and might lead to poor outcome. For those reasons and with the introduction of lumbar pedicle screws and cages lumbar fusions with instrumentations became a common procedure after laminectomy and decompression for lumbar spine stenosis.However, it is also known that there is a higher rate of complications in instrumented fusions in the elderly patients, such as pseudoarthrosis, adjacent segment disease, implant failure due to loosening and complications of related to the co-morbidity of such patients. For these reasons there was a need for less invasive strategies that provide a balance between safety and effectiveness.
A number of interspinous process devices have been recently introduced to the lumbar spinal market as an alternative to conventional surgical procedures in the treatment of symptomatic lumbar stenosis. The aim of implanting these interspinous devices is to unload the facet joints, restore foraminal height and provide spinal stability in order to improve the clinical outcome of surgery and increasing the cross sectional area of the lumbar canal by causing flexion in the implanted segment.
Objective:
The purpose of our prospective study is to evaluate the surgical outcome of the interspinous spacers versusdecompressive laminectomy in the management degenerative lumbar canal stenosis.
Methods:
This prospective comparative study includes two groups of patients that were operated upon in Ain Shams University hospitals and other hospital in the period between January 2010 to December 2013. In Group one (ISP) we treated 28 patients by implanting interspinous spacer (Coflex or X-Stop), group 2 (DL)25 patients were treated with decompressive laminectomy. Pre-and postoperative disability and pain scores were measured using the Oswestry disability index and visual analogue score.
The selection of surgical approach was according to the surgeon preference.
Results: Our statistical results revealed that there was no statistically significant difference in the outcome between the two groups regarding VAS for leg pain nor the ODI, however the improvement of back pain was better in the(DL) group.
The complications and reoperation rates was higher in the (ISP) group.
Other data
| Title | Evaluation of Interspinous DynamicStabilization in Lumbar CanalStenosis | Other Titles | تقييم التثبيت الديناميكى ما بين النامية الشوكية فى مداواة آلام ضيق القناة القطنية العصبية | Authors | Abou Bakr Gamal Ramadan | Issue Date | 2014 |
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