, Volume 36, Issue 2, pp 331-335
Date: 18 Dec 2012

Let’X-STOP with any “distraction” from the true problem: scenarios in which minimally invasive surgery is not welcome!

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We read with great interest the article of Alfieri et al. entitled: “Role of lumbar interspinous distraction on the neural elements” published in Neurosurgical Review [1]. In this study, the authors provide an excellent review about the clinical and experimental data currently available regarding the biomechanical effects of “intraspinous distraction” devices (IDDs).

Although the initial enthusiasm with IDDs as a possible safe, effective, and less invasive surgical alternative for relief of neurogenic claudication in patients with spinal stenosis [6, 10], recent studies have demonstrated not only less impressive clinical results but also a higher rate of complications (such as spinous process fractures and device dislocation) [2, 7] than the initial reports. Some series have estimated that in a mean follow-up of 40 months, up to 30 % of the patients submitted to implant of the X-STOP spacer®/IPD (the only FDA-approved interspinous device for use in the USA until the present moment) will ...