Advertisement

Interspinous and Interlaminar Devices for Decompression

  • Saqib Hasan
  • Hyun Bae
Chapter

Abstract

Interspinous and interlaminar devices are a type of motion-preserving implant designed to provide symptomatic relief of claudicatory lumbar spinal stenosis. These devices work via indirect decompression by maintaining mild flexion of a stenotic spinal segment, subsequently increasing the cross-sectional area of the spinal canal. The distractive force applied by the device, and the subsequent height restoration, is believed to be the main mechanism through which it functions. While these devices may primarily indirectly decompress a spinal motion segment via distraction, they also serve as an alternative to fusion by providing “dynamic stabilization” of a motion segment after direct decompression. The dynamic stabilization and distraction via the use of these spacers may also serve to diminish discogenic back pain from degenerative disc disease and facet degeneration. Benefits of these devices are that they can be implanted with a minimal degree of destruction to the local anatomy, they are more motion preserving than fusion, and they can be easily removed in cases of implant failure.

Keywords

Decompression Interlaminar implant Interspinous implant Spinal stenosis Spondylolisthesis 

References

  1. 1.
    Weinstein JN, Tosteson TD, Lurie JD, Tosteson AN, Blood E, Hanscom B, et al. Surgical versus nonsurgical therapy for lumbar spinal stenosis. N Engl J Med. 2008;358:794–810.PubMedPubMedCentralCrossRefGoogle Scholar
  2. 2.
    Herkowitz HN, Kurz LT. Degenerative lumbar spondylolisthesis with spinal stenosis. A prospective study comparing decompression with decompression and intertransverse process arthrodesis. J Bone Joint Surg Am. 1991;73:802–8.PubMedCrossRefPubMedCentralGoogle Scholar
  3. 3.
    Johnsson KE, Willner S, Johnsson K. Postoperative instability after decompression for lumbar spinal stenosis. Spine (Phila Pa 1976). 1986;11:107–10.CrossRefGoogle Scholar
  4. 4.
    Kleinstuck FS, Grob D, Lattig F, et al. The influence of preoperative back pain on the outcome of lumbar decompression surgery. Spine (Phila Pa 1976). 2009;34:1198–203.CrossRefGoogle Scholar
  5. 5.
    Katz JN, Lipson SJ, Chang LC, et al. Seven- to 10-year outcome of decompressive surgery for degenerative lumbar spinal stenosis. Spine (Phila Pa 1976). 1996;21:92–8.CrossRefGoogle Scholar
  6. 6.
    Katz JN, Stucki G, Lipson SJ, et al. Predictors of surgical outcome in degenerative lumbar spinal stenosis. Spine (Phila Pa 1976). 1999;24:2229–33.CrossRefGoogle Scholar
  7. 7.
    Etminan M, Girardi FP, Khan SN, Cammisa FP Jr. Revision strategies for lumbar pseudarthrosis. Orthop Clin North Am. 2002;33:381–92.PubMedCrossRefPubMedCentralGoogle Scholar
  8. 8.
    Cho W, Shimer AL, Shen FH. Complications associated with posterior lumbar surgery. Seminars in Spine Surgery. 2011;23:101–13.CrossRefGoogle Scholar
  9. 9.
    Park P, Garton HJ, Gala VC, Hoff JT, McGillicuddy JE. Adjacent segment disease after lumbar or lumbosacral fusion: review of the literature. Spine (Phila Pa 1976). 2004;29:1938–44.CrossRefGoogle Scholar
  10. 10.
    Gazzeri R, Galarza M, Neroni M, Fiore C, Faiola A, Puzzilli F, Callovini G, Alfieri A. Failure rates and complications of interspinous process decompression devices: a European multicenter study. Neurosurg Focus. 2015;39(4):E14.PubMedCrossRefPubMedCentralGoogle Scholar
  11. 11.
    Kim DH, Shanti N, Tantorski ME, Shaw JD, Li L, Martha JF, Thomas AJ, Parazin SJ, Rencus TC, Kwon B. Association between degenerative spondylolisthesis and spinous process fracture after interspinous process spacer surgery. Spine J. 2012;12(6):466–72.PubMedCrossRefGoogle Scholar
  12. 12.
    Schmier J, Halevi M, Maislin G, Ong K. Comparative cost effectiveness of Coflex & interlaminar stabilization versus instrumented posterolateral lumbar fusion for the treatment of lumbar spinal stenosis and spondylolisthesis. Clinicoecon Outcomes Res. 2014;6:125–31.PubMedPubMedCentralCrossRefGoogle Scholar
  13. 13.
    Bae HW, Davis RJ, Lauryssen C, Leary S, Maislin G, Musacchio MJ Jr. Three-year follow-up of the prospective, randomized, controlled trial of coflex interlaminar stabilization vs instrumented fusion in patients with lumbar stenosis. Neurosurgery. 2016;79(2):169–81.PubMedCrossRefPubMedCentralGoogle Scholar
  14. 14.
    Patel VV, Whang PG, Haley TR, et al. Superion interspinous process spacer for intermittent neurogenic claudication secondary to moderate lumbar spinal stenosis: two-year results from a randomized controlled FDA-IDE pivotal trial. Spine. 2015;40:275–82.PubMedCrossRefPubMedCentralGoogle Scholar
  15. 15.
    Swanson KE, Lindsey DP, Hsu KY, et al. The effects of an interspinous implant on intervertebral disc pressures. Spine. 2003;28:26–32.PubMedCrossRefPubMedCentralGoogle Scholar
  16. 16.
    Siddiqui M, Nicol M, Karadimas E, et al. The positional magnetic resonance imaging changes in the lumbar spine following insertion of a novel interspinous process distraction device. Spine. 2005;30:2677–82.PubMedCrossRefPubMedCentralGoogle Scholar
  17. 17.
    Wiseman CM, Lindsey DP, Fredrick AD, et al. The effect of an interspinous process implant on facet loading during extension. Spine. 2005;30:903–7.PubMedCrossRefPubMedCentralGoogle Scholar
  18. 18.
    Wilke HJ, Drumm J, Haussler K, et al. Biomechanical effect of different lumbar interspinous implants on flexibility and intradiscal pressure. Eur Spine J. 2008;17:1049–56.PubMedPubMedCentralCrossRefGoogle Scholar
  19. 19.
    Erbulut DU, Zafarparandeh I, Hassan CR, et al. Determination of the biomechanical effect of an interspinous process device on implanted and adjacent lumbar spinal segments using a hybrid testing protocol: a finite-element study. J Neurosurg Spine. 2015. undefined:1–9.Google Scholar
  20. 20.
    Richards JC, Majumdar S, Lindsey DP, et al. The treatment mechanism of an interspinous process implant for lumbar neurogenic intermittent claudication. Spine. 2005;30:744–9.PubMedCrossRefPubMedCentralGoogle Scholar
  21. 21.
    Tsai KJ, Murakami H, Lowery GL, et al. A biomechanical evaluation of an interspinous device (Coflex device) used to stabilize lumbar spine. Paradigm Spine J. 2006;1:14.Google Scholar
  22. 22.
    Epstein NE. A review of interspinous fusion devices: high complication, reoperation rates, and costs with poor outcomes. Surg Neurol Int. 2012;3:7.PubMedPubMedCentralCrossRefGoogle Scholar
  23. 23.
    Siddiqui M, Karadimas E, Nicol M, et al. Effects of X-STOP device on sagittal lumbar spine kinematics in spinal stenosis. J Spinal Disord Tech. 2006;19:328–33.PubMedCrossRefPubMedCentralGoogle Scholar
  24. 24.
    Schulte LM, O’Brien JR, Matteini LE, et al. Change in sagittal balance with placement of an interspinous spacer. Spine. 2011;36:E1302–5.PubMedCrossRefPubMedCentralGoogle Scholar
  25. 25.
    Zucherman JF, Hsu KY, Hartjen CA, et al. 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. 2005;30:1351–8.PubMedCrossRefPubMedCentralGoogle Scholar
  26. 26.
    Kuchta J, Sobottke R, Eysel P, et al. Two-year results of interspinous spacer (x-stop) implantation in 175 patients with neurologic intermittent claudication due to lumbar spinal stenosis. Eur Spine J. 2009;18:823–9.PubMedPubMedCentralCrossRefGoogle Scholar
  27. 27.
    Buric J, Pulidori M. Long-term reduction in pain and disability after surgery with the interspinous device for intervertebral assisted motion (diam) spinal stabilization system in patients with low back pain: 4-year follow-up from a longitudinal prospective case series. Eur Spine J. 2011;20:1304–11.PubMedPubMedCentralCrossRefGoogle Scholar
  28. 28.
    Moojen WA, Arts MP, Jacobs WC, et al. Interspinous process device versus standard conventional surgical decompression for lumbar spinal stenosis: randomized controlled trial. BMJ. 2013;347:f6415.PubMedPubMedCentralCrossRefGoogle Scholar
  29. 29.
    Stromqvist BH, Berg S, Gerdhem P, et al. X-stop versus decompressive surgery for lumbar neurogenic intermittent claudication: randomized controlled trial with 2-year follow-up. Spine. 2013;38:1436–42.PubMedCrossRefPubMedCentralGoogle Scholar
  30. 30.
    Patil CG, Sarmiento JM, Ugiliweneza B, et al. Interspinous device versus laminectomy for lumbar spinal stenosis: a comparative effectiveness study. Spine J. 2014;14:1484–92.PubMedCrossRefPubMedCentralGoogle Scholar
  31. 31.
    Wu AM, Zhou Y, Li QL, et al. Interspinous spacer versus traditional decompressive surgery for lumbar spinal stenosis: a systematic review and metaanalysis. PLoS One. 2014;9:e97142.PubMedPubMedCentralCrossRefGoogle Scholar
  32. 32.
    Davis RJ, Errico TJ, Bae H, et al. Decompression and coflex interlaminar stabilization compared with decompression and instrumented spinal fusion for spinal stenosis and low-grade degenerative spondylolisthesis: two-year results from the prospective, randomized, multicenter, food and drug administration investigational device exemption trial. Spine. 2013;38:1529–39.PubMedCrossRefPubMedCentralGoogle Scholar
  33. 33.
    Musacchio MJ, Lauryssen C, Davis RJ, Bae HW, Peloza JH, Guyer RD, Zigler JE, Ohnmeiss DD, Leary S. Evaluation of decompression and interlaminar stabilization compared with decompression and fusion for the treatment of lumbar spinal stenosis: 5-year follow-up of a prospective, randomized, controlled trial. Int J Spine Surg. 2016;10:6.PubMedPubMedCentralCrossRefGoogle Scholar
  34. 34.
    Schmidt S, Franke J, Rauschmann M, Adelt D, Bonsanto MM, Sola S. Prospective, randomized, multicenter study with 2-year follow-up to compare the performance of decompression with and without interlaminar stabilization. J Neurosurg Spine. 2018:1–10.Google Scholar
  35. 35.
    Gala RJ, Russo GS, Whang PG. Interspinous implants to treat spinal stenosis. Curr Rev Musculoskelet Med. 2017;10(2):182–8.PubMedPubMedCentralCrossRefGoogle Scholar
  36. 36.
    Nunley PD, Patel VV, Orndorff DG, Lavelle WF, Block JE, Geisler FH. Superion Interspinous spacer treatment of moderate spinal stenosis: 4-year results. World Neurosurg. 2017;104:279–83.PubMedCrossRefPubMedCentralGoogle Scholar
  37. 37.
    Försth P, Ólafsson G, Carlsson T, Frost A, Borgström F, Fritzell P, et al. A randomized, controlled trial of fusion surgery for lumbar spinal stenosis. N Engl J Med. 2016;374:1413–23.PubMedCrossRefPubMedCentralGoogle Scholar
  38. 38.
    Ghogawala Z, Dziura J, Butler WE, Dai F, Terrin N, Magge SN, et al. Laminectomy plus fusion versus laminectomy alone for lumbar spondylolisthesis. N Engl J Med. 2016;374:1424–34.PubMedCrossRefPubMedCentralGoogle Scholar
  39. 39.
    Röder C, Baumgärtner B, Berlemann U, Aghayev E. Superior outcomes of decompression with an interlaminar dynamic device versus decompression alone in patients with lumbar spinal stenosis and back pain: a cross registry study. Eur Spine J. 2015;24:2228–35.PubMedCrossRefPubMedCentralGoogle Scholar
  40. 40.
    Kumar N, Shah SM, Ng YH, Pannierselvam VK, Dasde S, Shen L. Role of Coflex as an adjunct to decompression for symptomatic lumbar spinal stenosis. Asian Spine J. 2014;8:161–9.PubMedPubMedCentralCrossRefGoogle Scholar
  41. 41.
    Moojen WA, Arts MP, Jacobs WC, van Zwet EW, van den Akker-van Marle ME, Koes BW, et al. Interspinous process device versus standard conventional surgical decompression for lumbar spinal stenosis: randomized controlled trial. BMJ. 2013;347:f6415.PubMedPubMedCentralCrossRefGoogle Scholar
  42. 42.
    Richter A, Schütz C, Hauck M, Halm H. Does an interspinous device (CoflexTM) 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. 2010;19:283–9.PubMedCrossRefPubMedCentralGoogle Scholar
  43. 43.
    Richter A, Halm HF, Hauck M, et al. Two-year follow-up after decompressive surgery with and without implantation of an interspinous device for lumbar spinal stenosis: a prospective controlled study. J Spinal Disord Tech. 2014;27:336–41.PubMedCrossRefPubMedCentralGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Saqib Hasan
    • 1
  • Hyun Bae
    • 1
  1. 1.Cedars Sinai Spine CenterLos AngelesUSA

Personalised recommendations