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Minimally Invasive Spine Surgery pp 255–262Cite as

Minimally Invasive Spinous Process Fixation and Fusion

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Abstract

Minimally invasive spinal techniques have been developed to minimize the perioperative morbidity associated with traditional, open spinal procedures, all the while maintaining similar or superior clinical outcomes. Interspinous rigid fixation/fusion devices (IFDs), which can be implanted in the lumbar spine through small midline incisions with minimal soft tissue dissection, allow for rigid spinal fixation, most commonly when implanted to supplement anterior, lateral, or posterior interbody fusions. These devices are distinct from the class of interspinous “bumpers” or spacers designed to distract the interspinous space and provide dynamic fixation. While an abundance of biomechanical data exists to support the use of IFDs, particularly as compared to stand-alone interbody, unilateral, or bilateral pedicle screw constructs, clinical studies reporting of surgical morbidity and patient outcomes are more sparse. The familiar surgical approach and minimal soft tissue dissection required for implantation of IFDs may mitigate both the steep learning curve required for minimally invasive posterior pedicle screw placement and perioperative morbidity, though more study is required to draw definitive conclusions.

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Author information

Authors and Affiliations

  1. Department of Neurosurgery, University of Miami Miller School of Medicine, Miami, FL, USA

    Jonathan N. Sellin & G. Damian Brusko

  2. Department of Neurological Surgery, University of Miami/Jackson Memorial Hospital, Miami, FL, USA

    Michael Y. Wang

Authors
  1. Jonathan N. Sellin
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  2. G. Damian Brusko
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  3. Michael Y. Wang
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Corresponding author

Correspondence to Jonathan N. Sellin .

Editor information

Editors and Affiliations

  1. Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA

    Frank M. Phillips

  2. Texas Back Institute Texas Health Presbyterian Hospital Plano Scoliosis and Spine Tumor Center, Plano, TX, USA

    Isador H. Lieberman

  3. Department of Orthopedic Surgery, University of Minnesota, Minneapolis, MN, USA

    David W. Polly Jr.

  4. Department of Neurological Surgery, University of Miami/Jackson Memorial Hospital, Miami, FL, USA

    Michael Y. Wang

Appendices

Quiz Questions

  1. 1.

    What distinguishes an interspinous fixation device (IFD) from an interspinous spacer or “bumper”?

  2. 2.

    True or false: Implantation of an IFD requires exposure of the facets and transverse processes bilaterally.

  3. 3.

    What is a common postoperative complication experienced by patients after IFD placement?

Answers

  1. 1.

    Interspinous fixation devices provide rigid fixation and are used as an adjunct to fusion; interspinous bumpers provide dynamic stabilization and are not intended to promote fusion.

  2. 2.

    False

  3. 3.

    Occult spinous process fractures

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Sellin, J.N., Brusko, G.D., Wang, M.Y. (2019). Minimally Invasive Spinous Process Fixation and Fusion. In: Phillips, F., Lieberman, I., Polly Jr., D., Wang, M. (eds) Minimally Invasive Spine Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-19007-1_24

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  • DOI: https://doi.org/10.1007/978-3-030-19007-1_24

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-19006-4

  • Online ISBN: 978-3-030-19007-1

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