Neurosurgical Review

, Volume 35, Issue 4, pp 477–484 | Cite as

Role of lumbar interspinous distraction on the neural elements

  • Alex Alfieri
  • Roberto Gazzeri
  • Julian Prell
  • Christian Scheller
  • Jens Rachinger
  • Christian Strauss
  • Andreas Schwarz
Review

Abstract

The interspinous distraction devices are used to treat variable pathologies ranging from facet syndrome, diskogenic low back pain, degenerative spinal stenosis, diskopathy, spondylolisthesis, and instability. The insertion of a posterior element with an interspinous device (ISD) is commonly judged responsive to a relative kyphosis of a lumbar segment with a moderate but persistent increase of the spinal canal and of the foraminal width and area, and without influence on low-grade spondylolisthesis. The consequence is the need of shared specific biomechanical concepts to give for each degenerative problem the right indication through a critical analysis of all available experimental and clinical biomechanical data. We reviewed systematically the available clinical and experimental data about kyphosis, enlargement of the spinal canal, distraction of the interspinous distance, increase of the neural foramina, ligamentous structures, load of the posterior annulus, intradiskal pressure, strength of the spinous processes, degeneration of the adjacent segment, complications, and cost-effectiveness of the ISD. The existing literature does not provide actual scientific evidence over the superiority of the ISD strategy, but most of the experimental and clinical data show a challenging potential. These considerations are applicable with different types of ISD with only few differences between the different categories. Despite—or because of—the low invasiveness of the surgical implantation of the ISD, this technique promises to play a major role in the future degenerative lumbar microsurgery. The main indications for ISD remain lumbar spinal stenoses and painful facet arthroses. A clear documented contraindication is the presence of an anterolisthesis. Nevertheless, the existing literature does not provide evidence of superiority of outcome and cost-effectiveness of the ISD strategy over laminectomy or other surgical procedures. At this time, the devices should be used in clinical randomized independent trials in order to obtain more information concerning the most advantageous optimal indication or, in selected cases, to treat tailored indications.

Keywords

Interspinous devices Degenerative lumbar spine Biomechanics of instability 

Notes

Conflict of interest

All the authors have no conflicts of interest.

References

  1. 1.
    Acosta FL Jr, Buckley JM, Xu Z, Lotz JC, Ames CP (2008) Biomechanical comparison of three fixation techniques for unstable thoracolumbar burst fractures. Laboratory investigation. J Neurosurg Spine 8(4):341–346PubMedCrossRefGoogle Scholar
  2. 2.
    Adams MA, Hutton WC, Stott JR (1980) The resistance to flexion of the lumbar intervertebral joint. Spine 5(3):245–253PubMedCrossRefGoogle Scholar
  3. 3.
    Anderson PA, Tribus CB, Kitchel SH (2006) Treatment of neurogenic claudication by interspinous decompression: application of the X STOP device in patients with lumbar degenerative spondylolisthesis. J Neurosurg Spine 4(6):463–471PubMedCrossRefGoogle Scholar
  4. 4.
    Barbagallo GM, Corbino LA, Olindo G, Foti P, Albanese V, Signorelli F (2010) The “sandwich phenomenon”: a rare complication in adjacent, double-level X-stop surgery: report of three cases and review of the literature. Spine Phila Pa 1976 35(3):E96–E100PubMedCrossRefGoogle Scholar
  5. 5.
    Barbagallo GM, Olindo G, Corbino L, Albanese V (2009) Analysis of complications in patients treated with the X-Stop Interspinous Process Decompression System: proposal for a novel anatomic scoring system for patient selection and review of the literature. Neurosurgery 65(1):111–119, discussion 119–120PubMedCrossRefGoogle Scholar
  6. 6.
    Bono CM, Vaccaro AR (2007) Interspinous process devices in the lumbar spine. J Spinal Disord Tech 20(3):255–261PubMedCrossRefGoogle Scholar
  7. 7.
    Bowers C, Amini A, Dailey AT, Schmidt MH (2010) Dynamic interspinous process stabilization: review of complications associated with the X-Stop device. Neurosurg Focus 28(6):E8PubMedCrossRefGoogle Scholar
  8. 8.
    Brantigan JW, Neidre A, Toohey JS (2004) The Lumbar I/F Cage for posterior lumbar interbody fusion with the variable screw placement system: 10-year results of a Food and Drug Administration clinical trial. Spine J 4(6):681–688PubMedCrossRefGoogle Scholar
  9. 9.
    Burnett MG, Stein SC, Bartels RH (2010) Cost-effectiveness of current treatment strategies for lumbar spinal stenosis: nonsurgical care, laminectomy, and X-STOP. J Neurosurg Spine 13(1):39–46PubMedCrossRefGoogle Scholar
  10. 10.
    Cabraja M, Abbushi A, Woiciechowsky C, Kroppenstedt S (2009) The short- and mid-term effect of dynamic interspinous distraction in the treatment of recurrent lumbar facet joint pain. Eur Spine J 18(11):1686–1694PubMedCrossRefGoogle Scholar
  11. 11.
    Chang KW, Dewei Z, McAfee PC, Warden KE, Farey ID, Gurr KR (1988) A comparative biomechanical study of spinal fixation using the combination spinal rod-plate and transpedicular screw fixation system. J Spinal Disord 1(4):257–266PubMedGoogle Scholar
  12. 12.
    Chou R, Baisden J, Carragee EJ, Resnick DK, Shaffer WO, Loeser JD (2009) Surgery for low back pain: a review of the evidence for an American Pain Society Clinical Practice Guideline. Spine (Phila Pa 1976) 34(10):1094–1109CrossRefGoogle Scholar
  13. 13.
    Christie SD, Song JK, Fessler RG (2005) Dynamic interspinous process technology. Spine (Phila Pa 1976) 30(16 Suppl):S73–S78CrossRefGoogle Scholar
  14. 14.
    Chung KJ, Hwang YS, Koh SH (2009) Stress fracture of bilateral posterior facet after insertion of interspinous implant. Spine (Phila Pa 1976) 34(10):E380–E383CrossRefGoogle Scholar
  15. 15.
    Cinotti G, De Santis P, Nofroni I, Postacchini F (2002) Stenosis of lumbar intervertebral foramen: anatomic study on predisposing factors. Spine 27(3):223–229PubMedCrossRefGoogle Scholar
  16. 16.
    Dickey JP, Kerr DJ (2003) Effect of specimen length: are the mechanics of individual motion segments comparable in functional spinal units and multisegment specimens? Med Eng Phys 25(3):221–227PubMedCrossRefGoogle Scholar
  17. 17.
    Disch AC, Knop C, Schaser KD, Blauth M, Schmoelz W (2008) Angular stable anterior plating following thoracolumbar corpectomy reveals superior segmental stability compared to conventional polyaxial plate fixation. Spine 33(13):1429–1437PubMedCrossRefGoogle Scholar
  18. 18.
    Disch AC, Schmoelz W, Matziolis G, Schneider SV, Knop C, Putzier M (2008) Higher risk of adjacent segment degeneration after floating fusions: long-term outcome after low lumbar spine fusions. J Spinal Disord Tech 21(2):79–85PubMedCrossRefGoogle Scholar
  19. 19.
    Elgafy H, Bellabarba C (2007) Three-column ligamentous extension injury of the thoracic spine: a case report and review of the literature. Spine 32(25):E785–E788PubMedCrossRefGoogle Scholar
  20. 20.
    Emami A, Deviren V, Berven S, Smith JA, Hu SS, Bradford DS (2002) Outcome and complications of long fusions to the sacrum in adult spine deformity: luque-galveston, combined iliac and sacral screws, and sacral fixation. Spine 27(7):776–786PubMedCrossRefGoogle Scholar
  21. 21.
    Floris R, Spallone A, Aref TY, Rizzo A, Apruzzese A, Mulas M, Simonetti G (1997) Early postoperative MRI findings following surgery for herniated lumbar disc. Acta Neurochir (Wien) 139(3):169–175CrossRefGoogle Scholar
  22. 22.
    Gillespie KA, Dickey JP (2004) Biomechanical role of lumbar spine ligaments in flexion and extension: determination using a parallel linkage robot and a porcine model. Spine 29(11):1208–1216PubMedCrossRefGoogle Scholar
  23. 23.
    Gotfried Y, Bradford DS, Oegema TR Jr (1986) Facet joint changes after chemonucleolysis-induced disc space narrowing. Spine 11(9):944–950PubMedCrossRefGoogle Scholar
  24. 24.
    Guehring T, Omlor GW, Lorenz H, Bertram H, Steck E, Richter W, Carstens C, Kroeber M (2005) Stimulation of gene expression and loss of anular architecture caused by experimental disc degeneration—an in vivo animal study. Spine 30(22):2510–2515PubMedCrossRefGoogle Scholar
  25. 25.
    Guehring T, Omlor GW, Lorenz H, Engelleiter K, Richter W, Carstens C, Kroeber M (2006) Disc distraction shows evidence of regenerative potential in degenerated intervertebral discs as evaluated by protein expression, magnetic resonance imaging, and messenger ribonucleic acid expression analysis. Spine 31(15):1658–1665PubMedCrossRefGoogle Scholar
  26. 26.
    Guehring T, Unglaub F, Lorenz H, Omlor G, Wilke HJ, Kroeber MW (2006) Intradiscal pressure measurements in normal discs, compressed discs and compressed discs treated with axial posterior disc distraction: an experimental study on the rabbit lumbar spine model. Eur Spine J 15(5):597–604PubMedCrossRefGoogle Scholar
  27. 27.
    Gunzburg R, Szpalski M (2003) The conservative surgical treatment of lumbar spinal stenosis in the elderly. Eur Spine J 12(Suppl 2):S176–S180PubMedCrossRefGoogle Scholar
  28. 28.
    Harrop JS, Youssef JA, Maltenfort M, Vorwald P, Jabbour P, Bono CM, Goldfarb N, Vaccaro AR, Hilibrand AS (2008) Lumbar adjacent segment degeneration and disease after arthrodesis and total disc arthroplasty. Spine 33(15):1701–1707PubMedCrossRefGoogle Scholar
  29. 29.
    Hasegawa K, Kitahara K, Hara T, Takano K, Shimoda H, Homma T (2008) Evaluation of lumbar segmental instability in degenerative diseases by using a new intraoperative measurement system. J Neurosurg Spine 8(3):255–262PubMedCrossRefGoogle Scholar
  30. 30.
    Hsu KY, Zucherman JF, Hartjen CA, Mehalic TF, Implicito DA, Martin MJ, Johnson DR 2nd, Skidmore GA, Vessa PP, Dwyer JW, Cauthen JC, Ozuna RM (2006) Quality of life of lumbar stenosis-treated patients in whom the X STOP interspinous device was implanted. J Neurosurg Spine 5(6):500–507PubMedCrossRefGoogle Scholar
  31. 31.
    Iguchi T, Kurihara A, Nakayama J, Sato K, Kurosaka M, Yamasaki K (2000) Minimum 10-year outcome of decompressive laminectomy for degenerative lumbar spinal stenosis. Spine 25(14):1754–1759PubMedCrossRefGoogle Scholar
  32. 32.
    Kandel R, Roberts S, Urban JP (2008) Tissue engineering and the intervertebral disc: the challenges. Eur Spine J 17(Suppl 4):480–491PubMedCrossRefGoogle Scholar
  33. 33.
    Kaneda K, Satoh S, Nohara Y, Oguma T (1985) Distraction rod instrumentation with posterolateral fusion in isthmic spondylolisthesis. 53 cases followed for 18–89 months. Spine (Phila Pa 1976) 10(4):383–389CrossRefGoogle Scholar
  34. 34.
    Kantelhardt SR, Torok E, Gempt J, Stoffel M, Ringel F, Stuer C, Meyer B (2010) Safety and efficacy of a new percutaneously implantable interspinous process device. Acta Neurochir (Wien) 152:1961–1967CrossRefGoogle Scholar
  35. 35.
    Khoo LT, Palmer S, Laich DT, Fessler RG (2002) Minimally invasive percutaneous posterior lumbar interbody fusion. Neurosurgery 51(5 Suppl):S166–S181PubMedGoogle Scholar
  36. 36.
    Kim DH, Albert TJ (2007) Interspinous process spacers. J Am Acad Orthop Surg 15(4):200–207PubMedGoogle Scholar
  37. 37.
    Kim JT, Jung CW, Lee JR, Min SW, Bahk JH (2003) Influence of lumbar flexion on the position of the intercrestal line. Reg Anesth Pain Med 28(6):509–511PubMedGoogle Scholar
  38. 38.
    Knop-Jergas BM, Zucherman JF, Hsu KY, DeLong B (1996) Anatomic position of a herniated nucleus pulposus predicts the outcome of lumbar discectomy. J Spinal Disord 9(3):246–250PubMedCrossRefGoogle Scholar
  39. 39.
    Kondrashov DG, Hannibal M, Hsu KY, Zucherman JF (2006) Interspinous process decompression with the X-STOP device for lumbar spinal stenosis: a 4-year follow-up study. J Spinal Disord Tech 19(5):323–327PubMedCrossRefGoogle Scholar
  40. 40.
    Kong DS, Kim ES, Eoh W (2007) One-year outcome evaluation after interspinous implantation for degenerative spinal stenosis with segmental instability. J Korean Med Sci 22(2):330–335PubMedCrossRefGoogle Scholar
  41. 41.
    Korovessis P, Repantis T, Zacharatos S, Zafiropoulos A (2009) Does Wallis implant reduce adjacent segment degeneration above lumbosacral instrumented fusion? Eur Spine J 18(6):830–840PubMedCrossRefGoogle Scholar
  42. 42.
    Lai PL, Chen LH, Niu CC, Fu TS, Chen WJ (2004) Relation between laminectomy and development of adjacent segment instability after lumbar fusion with pedicle fixation. Spine 29(22):2527–2532, discussion 2532PubMedCrossRefGoogle Scholar
  43. 43.
    Lazaro BC, Brasiliense LB, Sawa AG, Reyes PM, Theodore N, Sonntag VK, Crawford NR (2010) Biomechanics of a novel minimally invasive lumbar interspinous spacer: effects on kinematics, facet loads, and foramen height. Neurosurgery 66(3 Suppl Operative):126–132, discussion 132–123PubMedGoogle Scholar
  44. 44.
    Lee CH, Derby R, Choi HS, Lee SH, Kim SH, Kang YK (2010) The efficacy of two electrodes radiofrequency technique: comparison study using a cadaveric interspinous ligament and temperature measurement using egg white. Pain Physician 13(1):43–49PubMedGoogle Scholar
  45. 45.
    Lee J, Hida K, Seki T, Iwasaki Y, Minoru A (2004) An interspinous process distractor (X STOP) for lumbar spinal stenosis in elderly patients: preliminary experiences in 10 consecutive cases. J Spinal Disord Tech 17(1):72–77PubMedCrossRefGoogle Scholar
  46. 46.
    Lindsey DP, Swanson KE, Fuchs P, Hsu KY, Zucherman JF, Yerby SA (2003) The effects of an interspinous implant on the kinematics of the instrumented and adjacent levels in the lumbar spine. Spine 28(19):2192–2197PubMedCrossRefGoogle Scholar
  47. 47.
    Lisi AJ, O'Neill CW, Lindsey DP, Cooperstein R, Cooperstein E, Zucherman JF (2006) Measurement of in vivo lumbar intervertebral disc pressure during spinal manipulation: a feasibility study. J Appl Biomech 22(3):234–239PubMedGoogle Scholar
  48. 48.
    Liu G, Zhao JN, Dezawa A (2008) Endoscopic decompression combined with interspinous process implant fusion for lumbar spinal stenosis. Chin J Traumatol 11(6):364–367PubMedGoogle Scholar
  49. 49.
    Lysack JT, Dickey JP, Dumas GA, Yen D (2000) A continuous pure moment loading apparatus for biomechanical testing of multi-segment spine specimens. J Biomech 33(6):765–770PubMedCrossRefGoogle Scholar
  50. 50.
    Minns RJ, Walsh WK (1997) Preliminary design and experimental studies of a novel soft implant for correcting sagittal plane instability in the lumbar spine. Spine (Phila Pa 1976) 22(16):1819–1825, discussion 1826–1817CrossRefGoogle Scholar
  51. 51.
    Moojen WA, Arts MP, Brand R, Koes BW, Peul WC (2010) The Felix-trial. Double-blind randomization of interspinous implant or bony decompression for treatment of spinal stenosis related intermittent neurogenic claudication. BMC Musculoskelet Disord 11:100PubMedCrossRefGoogle Scholar
  52. 52.
    Moon MS, Kim SS, Sun DH, Moon YW (1994) Anterior spondylodesis for spondylolisthesis: isthmic and degenerative types. Eur Spine J 3(3):172–176PubMedCrossRefGoogle Scholar
  53. 53.
    Moon MS, Moon JL, Ha KY, Kim KW (2000) Re: Does spinal kyphotic deformity influence the biomechanical characteristics of the adjacent motion segment? An in vivo animal model. Spine 25(13):1739–1741PubMedCrossRefGoogle Scholar
  54. 54.
    Murata H, Sakai T, Goto S, Sumikawa K (2008) Three-dimensional computed tomography for difficult thoracic epidural needle placement. Anesth Analg 106(2):654–658PubMedCrossRefGoogle Scholar
  55. 55.
    Nardi P, Cabezas D, Rea G, Pettorini BL (2010) Aperius PercLID stand alone interspinous system for the treatment of degenerative lumbar stenosis: experience on 152 cases. J Spinal Disord Tech 23(3):203–207PubMedCrossRefGoogle Scholar
  56. 56.
    Omlor GW, Lorenz H, Engelleiter K, Richter W, Carstens C, Kroeber MW, Guehring T (2006) Changes in gene expression and protein distribution at different stages of mechanically induced disc degeneration—an in vivo study on the New Zealand white rabbit. J Orthop Res 24(3):385–392PubMedCrossRefGoogle Scholar
  57. 57.
    Oxland TR, Panjabi MM, Southern EP, Duranceau JS (1991) An anatomic basis for spinal instability: a porcine trauma model. J Orthop Res 9(3):452–462PubMedCrossRefGoogle Scholar
  58. 58.
    Panjabi MM, Goel VK, Takata K (1982) Physiologic strains in the lumbar spinal ligaments. An in vitro biomechanical study. 1981 Volvo Award in biomechanics. Spine 7(3):192–203PubMedCrossRefGoogle Scholar
  59. 59.
    Perez-Grueso FS, Fernandez-Baillo N, Arauz de Robles S, Garcia Fernandez A (2000) The low lumbar spine below Cotrel-Dubousset instrumentation: long-term findings. Spine 25(18):2333–2341PubMedCrossRefGoogle Scholar
  60. 60.
    Pintar FA, Yoganandan N, Myers T, Elhagediab A, Sances A Jr (1992) Biomechanical properties of human lumbar spine ligaments. J Biomech 25(11):1351–1356PubMedCrossRefGoogle Scholar
  61. 61.
    Ploumis A, Wu C, Fischer G, Mehbod AA, Wu W, Faundez A, Transfeldt EE (2008) Biomechanical comparison of anterior lumbar interbody fusion and transforaminal lumbar interbody fusion. J Spinal Disord Tech 21(2):120–125PubMedCrossRefGoogle Scholar
  62. 62.
    Raja Rampersaud Y, Fisher C, Wilsey J, Arnold P, Anand N, Bono CM, Dailey AT, Dvorak M, Fehlings MG, Harrop JS, Oner FC, Vaccaro AR (2006) Agreement between orthopedic surgeons and neurosurgeons regarding a new algorithm for the treatment of thoracolumbar injuries: a multicenter reliability study. J Spinal Disord Tech 19(7):477–482PubMedCrossRefGoogle Scholar
  63. 63.
    Reinhardt A, Hufnagel S (2010) Longterm results of the interspinous spacer X-STOP. Der Orthopade 39(6):573–579PubMedCrossRefGoogle Scholar
  64. 64.
    Richards JC, Majumdar S, Lindsey DP, Beaupre GS, Yerby SA (2005) The treatment mechanism of an interspinous process implant for lumbar neurogenic intermittent claudication. Spine 30(7):744–749PubMedCrossRefGoogle Scholar
  65. 65.
    Richter A, Schutz C, Hauck M, Halm H (2010) 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. Eur Spine J 19(2):283–289PubMedCrossRefGoogle Scholar
  66. 66.
    Richter HP, Kast E, Tomczak R, Besenfelder W, Gaus W (2001) Results of applying ADCON-L gel after lumbar discectomy: the German ADCON-L study. J Neurosurg 95(2 Suppl):179–189PubMedGoogle Scholar
  67. 67.
    Rohlmann A, Zander T, Burra NK, Bergmann G (2005) Effect of an interspinous implant on loads in the lumbar spine. Biomed Tech 50(10):343–347CrossRefGoogle Scholar
  68. 68.
    Schaller B (2004) Failed back surgery syndrome: the role of symptomatic segmental single-level instability after lumbar microdiscectomy. Eur Spine J 13(3):193–198PubMedCrossRefGoogle Scholar
  69. 69.
    Schoeggl A, Maier H, Saringer W, Reddy M, Matula C (2002) Outcome after chronic sciatica as the only reason for lumbar microdiscectomy. J Spinal Disord Tech 15(5):415–419PubMedCrossRefGoogle Scholar
  70. 70.
    Schofferman L, Schofferman J, Zucherman J, Gunthorpe H, Hsu K, Picetti G, Goldthwaite N, White A (1989) Occult infections causing persistent low-back pain. Spine 14(4):417–419PubMedCrossRefGoogle Scholar
  71. 71.
    Senegas J (2002) Mechanical supplementation by non-rigid fixation in degenerative intervertebral lumbar segments: the Wallis system. Eur Spine J 11(Suppl 2):S164–S169PubMedGoogle Scholar
  72. 72.
    Senegas J, Vital JM, Pointillart V, Mangione P (2009) Clinical evaluation of a lumbar interspinous dynamic stabilization device (the Wallis system) with a 13-year mean follow-up. Neurosurg Rev 32(3):335–341, discussion 341–332PubMedCrossRefGoogle Scholar
  73. 73.
    Sharrock NE (1979) Recordings of, and an anatomical explanation for, false positive loss of resistance during lumbar extradural analgesia. Br J Anaesth 51(3):253–258PubMedCrossRefGoogle Scholar
  74. 74.
    Shepherd DE, Leahy JC, Mathias KJ, Wilkinson SJ, Hukins DW (2000) Spinous process strength. Spine 25(3):319–323PubMedCrossRefGoogle Scholar
  75. 75.
    Shim CS, Park SW, Lee SH, Lim TJ, Chun K, Kim DH (2008) Biomechanical evaluation of an interspinous stabilizing device, Locker. Spine 33(22):820–827CrossRefGoogle Scholar
  76. 76.
    Siddiqui M, Smith FW, Wardlaw D (2007) One-year results of X Stop interspinous implant for the treatment of lumbar spinal stenosis. Spine 32(12):1345–1348PubMedCrossRefGoogle Scholar
  77. 77.
    Sobottke R, Schluter-Brust K, Kaulhausen T, Rollinghoff M, Joswig B, Stutzer H, Eysel P, Simons P, Kuchta J (2009) Interspinous implants (X Stop, Wallis, Diam) for the treatment of LSS: is there a correlation between radiological parameters and clinical outcome? Eur Spine J 18(10):1494–1503PubMedCrossRefGoogle Scholar
  78. 78.
    Steib JP, Aoui M, Mitulescu A, Bogorin I, Chiffolot X, Cognet JM, Simon P (2006) Thoracolumbar fractures surgically treated by “in situ contouring”. Eur Spine J 15(12):1823–1832PubMedCrossRefGoogle Scholar
  79. 79.
    Tai CL, Hsieh PH, Chen WP, Chen LH, Chen WJ, Lai PL (2008) Biomechanical comparison of lumbar spine instability between laminectomy and bilateral laminotomy for spinal stenosis syndrome—an experimental study in porcine model. BMC Musculoskelet Disord 9:84PubMedCrossRefGoogle Scholar
  80. 80.
    Talwar V, Lindsey DP, Fredrick A, Hsu KY, Zucherman JF, Yerby SA (2006) Insertion loads of the X STOP interspinous process distraction system designed to treat neurogenic intermittent claudication. Eur Spine J 15(6):908–912PubMedCrossRefGoogle Scholar
  81. 81.
    Terk MR, Hume-Neal M, Fraipont M, Ahmadi J, Colletti PM (1997) Injury of the posterior ligament complex in patients with acute spinal trauma: evaluation by MR imaging. AJR Am J Roentgenol 168(6):1481–1486PubMedGoogle Scholar
  82. 82.
    Tosteson AN, Lurie JD, Tosteson TD, Skinner JS, Herkowitz H, Albert T, Boden SD, Bridwell K, Longley M, Andersson GB, Blood EA, Grove MR, Weinstein JN (2008) Surgical treatment of spinal stenosis with and without degenerative spondylolisthesis: cost-effectiveness after 2 years. Ann Intern Med 149(12):845–853PubMedGoogle Scholar
  83. 83.
    Trautwein FT, Lowery GL, Wharton ND, Hipp JA, Chomiak RJ (2010) Determination of the in vivo posterior loading environment of the Coflex interlaminar-interspinous implant. Spine J 10(3):244–251PubMedCrossRefGoogle Scholar
  84. 84.
    Tsai KJ, Murakami H, Lowery GL, Hutton WC (2006) A biomechanical evaluation of an interspinous device (Coflex) used to stabilize the lumbar spine. J Surg Orthop Adv 15(3):167–172PubMedGoogle Scholar
  85. 85.
    Tsuji H, Hirano N, Katoh Y, Ohsima H, Ishihara H, Matsui H, Hayashi Y (1990) Ceramic interspinous block (CISB) assisted anterior interbody fusion. J Spinal Disord 3(1):77–86PubMedCrossRefGoogle Scholar
  86. 86.
    Ulivieri S, Petrini C, Oliveri G (2010) X-Stop interspinous implant for the treatment of lumbar spinal stenosis. Our experience after 50 consecutive patients. Il Giornale di chirurgia 31(5):247–250PubMedGoogle Scholar
  87. 87.
    Unglaub F, Guehring T, Lorenz H, Carstens C, Kroeber MW (2005) Effects of unisegmental disc compression on adjacent segments: an in vivo animal model. Eur Spine J 14(10):949–955PubMedCrossRefGoogle Scholar
  88. 88.
    Unglaub F, Guehring T, Omlor G, Lorenz H, Carstens C, Kroeber MW (2006) Controlled distraction as a therapeutic option in moderate degeneration of the intervertebral disc—an in vivo study in the rabbit-spine model. Z Orthop 144(1):68–73PubMedCrossRefGoogle Scholar
  89. 89.
    Urban JP, Roberts S (2003) Degeneration of the intervertebral disc. Arthritis Res Ther 5(3):120–130PubMedCrossRefGoogle Scholar
  90. 90.
    Vaccaro, A. R., Lee, J. Y., Schweitzer, K. M., Jr., Lim, M. R., Baron, E. M., Oner, F. C., Hulbert, R. J., Hedlund, R., Fehlings, M. G., Arnold, P., Harrop, J., Bono, C. M., Anderson, P. A., Anderson, D. G., Harris, M. B., and Spine Trauma Study, G (2006) Assessment of injury to the posterior ligamentous complex in thoracolumbar spine trauma. Spine J 6(5):524–528CrossRefGoogle Scholar
  91. 91.
    Vadapalli S, Robon M, Biyani A, Sairyo K, Khandha A, Goel VK (2006) Effect of lumbar interbody cage geometry on construct stability: a cadaveric study. Spine 31(19):2189–2194PubMedCrossRefGoogle Scholar
  92. 92.
    Weinstein JN, Tosteson TD, Lurie JD, Tosteson A, Blood E, Herkowitz H, Cammisa F, Albert T, Boden SD, Hilibrand A, Goldberg H, Berven S, An H (2010) Surgical versus nonoperative treatment for lumbar spinal stenosis four-year results of the Spine Patient Outcomes Research Trial. Spine (Phila Pa 1976) 35(14):1329–1338Google Scholar
  93. 93.
    Weinstein JN, Tosteson TD, Lurie JD, Tosteson AN, Blood E, Hanscom B, Herkowitz H, Cammisa F, Albert T, Boden SD, Hilibrand A, Goldberg H, Berven S, An H (2008) Surgical versus nonsurgical therapy for lumbar spinal stenosis. N Engl J Med 358(8):794–810PubMedCrossRefGoogle Scholar
  94. 94.
    White AH, von Rogov P, Zucherman J, Heiden D (1987) Lumbar laminectomy for herniated disc: a prospective controlled comparison with internal fixation fusion. Spine 12(3):305–307PubMedCrossRefGoogle Scholar
  95. 95.
    Wilke HJ, Drumm J, Haussler K, Mack C, Steudel WI, Kettler A (2008) Biomechanical effect of different lumbar interspinous implants on flexibility and intradiscal pressure. Eur Spine J 17(8):1049–1056PubMedCrossRefGoogle Scholar
  96. 96.
    Xu HZ, Wang XY, Chi YL, Zhu QA, Lin Y, Huang QS, Dai LY (2006) Biomechanical evaluation of a dynamic pedicle screw fixation device. Clin Biomech (Bristol, Avon) 21(4):330–336CrossRefGoogle Scholar
  97. 97.
    Yahia H, Newman N (1989) A light and electron microscopic study of spinal ligament innervation. Z Mikrosk Anat Forsch 103(4):664–674PubMedGoogle Scholar
  98. 98.
    Yahia LH, Garzon S, Strykowski H, Rivard CH (1990) Ultrastructure of the human interspinous ligament and ligamentum flavum. A preliminary study. Spine 15(4):262–268PubMedCrossRefGoogle Scholar
  99. 99.
    Yano S, Hida K, Seki T, Aoyama T, Akino M, Iwasaki Y (2008) A new ceramic interspinous process spacer for lumbar spinal canal stenosis. Neurosurgery 63(1 Suppl 1):ONS108–ONS113, discussion ONS114PubMedCrossRefGoogle Scholar
  100. 100.
    Zarzur E (1984) Anatomic studies of the human ligamentum flavum. Anesth Analg 63(5):499–502PubMedCrossRefGoogle Scholar
  101. 101.
    Zucherman J, Hsu K, Picetti G 3rd, White A, Wynne G, Taylor L (1992) Clinical efficacy of spinal instrumentation in lumbar degenerative disc disease. Spine 17(7):834–837PubMedCrossRefGoogle Scholar
  102. 102.
    Zucherman JF, Hsu KY, Hartjen CA, Mehalic TF, Implicito DA, Martin MJ, Johnson DR 2nd, Skidmore GA, Vessa PP, Dwyer JW, Puccio S, Cauthen JC, Ozuna RM (2004) A prospective randomized multi-center study for the treatment of lumbar spinal stenosis with the X STOP interspinous implant: 1-year results. Eur Spine J 13(1):22–31PubMedCrossRefGoogle Scholar
  103. 103.
    Zucherman JF, Hsu KY, Hartjen CA, Mehalic TF, Implicito DA, Martin MJ, Johnson DR 2nd, Skidmore GA, Vessa PP, Dwyer JW, Puccio ST, Cauthen JC, Ozuna RM (2005) A multicenter, prospective, randomized trial evaluating the X STOP interspinous process decompression system for the treatment of neurogenic intermittent claudication: two-year follow-up results. Spine 30(12):1351–1358PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Alex Alfieri
    • 1
  • Roberto Gazzeri
    • 3
  • Julian Prell
    • 1
  • Christian Scheller
    • 1
  • Jens Rachinger
    • 1
  • Christian Strauss
    • 1
  • Andreas Schwarz
    • 2
  1. 1.Department of NeurosurgeryMartin Luther University Halle-WittenbergHalle (Saale)Germany
  2. 2.NeurosurgeryCentral General HospitalBozenItaly
  3. 3.NeurosurgerySan Giovanni Addolorata HospitalRomeItaly

Personalised recommendations