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Percutaneous interspinous distraction device for the treatment of lumbar spinal canal stenosis: clinical and radiographic results at 2-year follow-up.

Yingsakmongkol W, Chaichankul C, Limthongkul W - Int J Spine Surg (2014)

Bottom Line: The mean VAS score of back pain decreased significantly (p < 0.05).The device offers significant decrease in back pain, leg pain and ODI score with 2-year lasting relief from symptoms.A very weak correlation between the radiographic changes and improvement of pain was found.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.

ABSTRACT

Objective: To evaluate the effectiveness of the In- space (Synthes, Umkirch, Germany) and the correlation between radiographic parameters and clinical outcome in patients with lumbar spinal canal stenosis (LSS).

Methods: Between June 2009 and May 2013, 56 patients with LSS underwent In-space by one senior surgeon. All of the patients were evaluated both clinically and radiographic measurements before the procedure and each visit at the postoperative follow-up. Preoperative and postoperative X-ray imaging was performed before the procedure and at follow-up to assess the correlation with the clinical outcome. Radiological measurements and clinical outcomes were recorded to establish a relationship between the radiographic parameters and clinical outcome of this procedure. All patients had at least 2 years of follow-up.

Results: The mean VAS score of back pain decreased significantly (p < 0.05).

Conclusions: Our data suggest that percutaneous interspinous devices are a good alternative to treat LSS. The device offers significant decrease in back pain, leg pain and ODI score with 2-year lasting relief from symptoms. The increased intervertebral foramenal space explains the improvement of leg pain, but the mechanism of back pain relief remains unclear. A very weak correlation between the radiographic changes and improvement of pain was found.

No MeSH data available.


Related in: MedlinePlus

The In-space device (Synthes, Umkirch, Germany).
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Figure 0001: The In-space device (Synthes, Umkirch, Germany).

Mentions: Lumbar spinal canal stenosis (LSS) is one of the most common degenerative spinal disorders. Treatment of symptomatic LSS includes conservative and surgical management. The treatment options may vary from activity modification, nonsteroidal anti-inflammatory drugs, physiotherapy, and epidural injection for those with mild symptoms or unfit for surgery to surgical decompression with or without fusion in patients who fail to respond to conservative measures. Several studies 1–5 reported that surgical treatment showed significantly more improvement in outcome than nonsurgical treatment. Recently, minimally invasive spine surgery has been increasing role in treatment of several spinal conditions. Various interspinous spacers such as Diam (Medtronic, Memphis, Tennessee, USA), Wallis (Abbott Spine, Austin, Texas, USA) and X Stop (Medtronic, Memphis, Tennessee, USA) have been introduced for an alternative treatment.6–14 There are some studies reported the outcomes of these treatments. The In-space (Synthes, Umkirch, Germany) (Figure 1) is a new percutaneous device considered for the treatment of LSS. The In-space device is a PEEK (polyether-ether ketone) material radiolucent body, which is undisturbed visualization by screw and wings made of titanium alloy to allow proper radiographic assessment of, implant position. It is available in 5 different sizes from 8 to 16 mm (in 2 mm increments). According to limited of clinical trials and clinical outcome data, the efficacy of this procedure still remains controversy. However, best to our knowledge, no study has yet been reported the correlation between radiographic measurements after implantation of the In-space device and clinical outcome.


Percutaneous interspinous distraction device for the treatment of lumbar spinal canal stenosis: clinical and radiographic results at 2-year follow-up.

Yingsakmongkol W, Chaichankul C, Limthongkul W - Int J Spine Surg (2014)

The In-space device (Synthes, Umkirch, Germany).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4325485&req=5

Figure 0001: The In-space device (Synthes, Umkirch, Germany).
Mentions: Lumbar spinal canal stenosis (LSS) is one of the most common degenerative spinal disorders. Treatment of symptomatic LSS includes conservative and surgical management. The treatment options may vary from activity modification, nonsteroidal anti-inflammatory drugs, physiotherapy, and epidural injection for those with mild symptoms or unfit for surgery to surgical decompression with or without fusion in patients who fail to respond to conservative measures. Several studies 1–5 reported that surgical treatment showed significantly more improvement in outcome than nonsurgical treatment. Recently, minimally invasive spine surgery has been increasing role in treatment of several spinal conditions. Various interspinous spacers such as Diam (Medtronic, Memphis, Tennessee, USA), Wallis (Abbott Spine, Austin, Texas, USA) and X Stop (Medtronic, Memphis, Tennessee, USA) have been introduced for an alternative treatment.6–14 There are some studies reported the outcomes of these treatments. The In-space (Synthes, Umkirch, Germany) (Figure 1) is a new percutaneous device considered for the treatment of LSS. The In-space device is a PEEK (polyether-ether ketone) material radiolucent body, which is undisturbed visualization by screw and wings made of titanium alloy to allow proper radiographic assessment of, implant position. It is available in 5 different sizes from 8 to 16 mm (in 2 mm increments). According to limited of clinical trials and clinical outcome data, the efficacy of this procedure still remains controversy. However, best to our knowledge, no study has yet been reported the correlation between radiographic measurements after implantation of the In-space device and clinical outcome.

Bottom Line: The mean VAS score of back pain decreased significantly (p < 0.05).The device offers significant decrease in back pain, leg pain and ODI score with 2-year lasting relief from symptoms.A very weak correlation between the radiographic changes and improvement of pain was found.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.

ABSTRACT

Objective: To evaluate the effectiveness of the In- space (Synthes, Umkirch, Germany) and the correlation between radiographic parameters and clinical outcome in patients with lumbar spinal canal stenosis (LSS).

Methods: Between June 2009 and May 2013, 56 patients with LSS underwent In-space by one senior surgeon. All of the patients were evaluated both clinically and radiographic measurements before the procedure and each visit at the postoperative follow-up. Preoperative and postoperative X-ray imaging was performed before the procedure and at follow-up to assess the correlation with the clinical outcome. Radiological measurements and clinical outcomes were recorded to establish a relationship between the radiographic parameters and clinical outcome of this procedure. All patients had at least 2 years of follow-up.

Results: The mean VAS score of back pain decreased significantly (p < 0.05).

Conclusions: Our data suggest that percutaneous interspinous devices are a good alternative to treat LSS. The device offers significant decrease in back pain, leg pain and ODI score with 2-year lasting relief from symptoms. The increased intervertebral foramenal space explains the improvement of leg pain, but the mechanism of back pain relief remains unclear. A very weak correlation between the radiographic changes and improvement of pain was found.

No MeSH data available.


Related in: MedlinePlus