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A New Interlaminar/Interspinous and Facet-Joint Stabilization System in Lumbar Degenerative Disk Disease: 2 Years of Results

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The Funnel: From the Skull Base to the Sacrum

Part of the book series: Acta Neurochirurgica Supplement ((NEUROCHIRURGICA,volume 135))

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Abstract

Introduction: In lumbar degenerative disk diseases (DDDs), we include a wide range of lumbar pathologies. Lumbar spinal stenosis with or without spondylolisthesis is a common cause of lower-limb pain in elderly patients. The surgical treatment of lumbar DDD consists of the decompression of the neural structures or the decompression and fusion of the involved motion segment. Unfortunately, rigid spinal implants followed by fusion cause increased stresses on the neighboring spinal segments, often leading to adjacent segment degeneration. The aim of this paper is to present a new system for interlaminar/interspinous and facet-joint stabilization and fusion.

Material and Methods: From March 2018 to June 2021, 175 patients with severe lumbar back and/or leg pain were operated on with this device after the failure of conservative treatment for a minimum of 6 months. For this study, we considered 75 available patients with a minimum follow-up time of 24 months. Patients rated their back pain and leg pain on a visual analog scale (VAS) after surgery and at the last follow-up; also, the postoperative consumption of analgesic drugs was investigated. Finally, patients were asked whether they would undergo this kind of surgery again or recommend it. The device is designed to promote a better and more efficient intervertebral fusion: Bone Ingrowth technology allows the system to achieve the best response from the bone tissue.

Results: All procedures were performed without any complications. A reoperation was required in five cases (6.7%) because of implant failure. In one case, a spinous process and unilateral articular process fracture occurred. In four cases, a subcutaneous ISCHIA (one case) or FILICUDI (three cases) pullout was observed. Significant improvements following lumbar surgery were observed when evaluating the postoperative VAS values, analgesic drug consumption levels, and patients’ satisfaction ratings. Evident fusion was seen in 58 of 75 patients (77.3%).

Conclusions: Our interspinous/interlaminar and facet-joint implant solution, associated with bone grafting, provided vertebral fusion in most stenotic patients with Grade I DS undergoing bilateral microdecompression (BMD) or bilateral decompression via the unilateral approach (BDUA). A higher number of patients and a longer follow-up will certainly be required to completely validate these new devices, but this minimally invasive surgery (MIS) is currently very encouraging and satisfactory.

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Abbreviations

ASD:

Adjacent segment degeneration

BDUA:

Bilateral decompression via the unilateral approach

BMD:

Bilateral microdecompression

DDD:

Degenerative disk disease

DS:

Degenerative spondylolisthesis

ILIF:

Interspinous/interlaminar lumbar instrumented fusion

VAS:

Visual analog scale

References

  1. Gibson JN, Waddell G. Surgery for degenerative lumbar spondylosis: updated Cochrane review. Spine (Phila Pa 1976). 2005;30:2312–20.

    Article  PubMed  Google Scholar 

  2. Postacchini F. Management of lumbar spinal stenosis. J Bone Joint Surg Br. 1996;78:154–64.

    Article  CAS  PubMed  Google Scholar 

  3. Andersson GB. Epidemiological features of chronic lowback pain. Lancet. 1999;354:581–5.

    Article  CAS  PubMed  Google Scholar 

  4. Weinstein JN, Lurie JD, Tosteson TD, Zhao W, Blood EA, et al. Surgical compared with nonoperative treatment for lumbar degenerative spondylolisthesis. Four-year results in the Spine Patient Outcomes Research Trial (SPORT) randomized and observational cohorts. J Bone Joint Surg Am. 2009;91:1295–304.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Thome C, Zevgaridis D, Leheta O, Bazner H, Pockler-Schoniger C, et al. Outcome after less-invasive decompression of lumbar spinal stenosis: a randomized comparison of unilateral laminotomy, bilateral laminotomy, and laminectomy. J Neurosurg Spine. 2005;3:129–41.

    Article  PubMed  Google Scholar 

  6. Macki M, Alvi MA, Kerezoudis P, et al. Predictors of patient dissatisfaction at 1 and 2 years after lumbar surgery [published online ahead of print, 2019 Nov 22]. J Neurosurg Spine. 2019:1–10. https://doi.org/10.3171/2019.8.SPINE19260.

  7. Okuda S, Iwasaki M, Miyauchi A, Aono H, Morita M, Yamamoto T. Risk factors for adjacent segment degeneration after PLIF. Spine (Phila Pa 1976). 2004;29:1535–40.

    Article  PubMed  Google Scholar 

  8. Kim TH, Lee BH, Moon SH, Lee SH, Lee HM. Comparison of adjacent segment degeneration after successful posterolateral fusion with unilateral or bilateral pedicle screw instrumentation: a minimum 10year follow-up. Spine J. 2013;13:1208–16.

    Article  PubMed  Google Scholar 

  9. Amato V, Giannachi L, Irace C, Corona C. Accuracy of pedicle screw placement in the lumbosacral spine using conventional technique: computed tomography postoperative assessment in 102 consecutive patients. J Neurosurg Spine. 2010;12:306–13.

    Article  PubMed  Google Scholar 

  10. Raley DA, Mobbs RJ. Retrospective computed tomography scan analysis of percutaneously inserted pedicle screws for posterior transpedicular stabilization of the thoracic and lumbar spine: accuracy and complication rates. Spine (Phila Pa 1976). 2012;37:1092–100.

    Article  PubMed  Google Scholar 

  11. Lee SH, Lee JH, Hong SW, Chung SE, Yoo SH, et al. Spinopelvic alignment after interspinous soft stabilization with a tension band system in grade 1 degenerative lumbar spondylolisthesis. Spine (Phila Pa 1976). 2010;35:E691–701.

    Article  PubMed  Google Scholar 

  12. Gibson JN, Depreitere B, Pflugmacher R, Schnake KJ, Fielding LC, et al. Decompression and paraspinous tension band: a novel treatment method for patients with lumbar spinal stenosis and degenerative spondylolisthesis. Spine J. 2015;15:S23–32.

    Article  PubMed  Google Scholar 

  13. Mulconrey DS. Fluoroscopic radiation exposure in spinal surgery: in vivo evaluation for operating room personnel. Clin Spine Surg. 2016;29(7):E331–5.

    Article  PubMed  Google Scholar 

  14. Ghezelbash F, Schmidt H, Shirazi-Adl A, El-Rich M. Internal load shering in the human passive lumbar spine: review of in virto an finite element model studies. J Biomech. 2020;102:109441.

    Article  PubMed  Google Scholar 

  15. Natarajan RN, Watanabe K, Hasegawa K. Posterior bone graft in lumbar spine surgery reduces the stress in the screw-rod system—a finite element study. J Mech Behav Biomed Mater. 2020;104:103628.

    Article  PubMed  Google Scholar 

  16. Meyerding HW. Spondyloptosis. Surg Gynaecol Obstet. 1932;54:371–7.

    Google Scholar 

  17. Senegas J, Etchevers JP, Vital JM, et al. Le recalibrage du canal lombaire, alternative à la laminectomie dans le traitement des sténoses du canal lombaire. Rev Chir Orthop Reparatrice Appar Mot. 1988;74(Suppl. 2):15–22.

    CAS  PubMed  Google Scholar 

  18. Aryanpur J, Ducker T. Multilevel lumbar laminotomies: an alternative to laminectomy in the treatment of lumbar stenosis. Neurosurgery. 1990;26:429–32.

    Article  CAS  PubMed  Google Scholar 

  19. Hong SW, Choi KY, Ahn Y, et al. A comparison of unilateral and bilateral laminotomies for decompression of L4-L5 spinal stenosis. Spine (Phila Pa 1976). 2011;36:E172–8.

    Article  PubMed  Google Scholar 

  20. Sasai K, Umeda M, Maruyama T, Wakabayashi E, Iida H. Microsurgical bilateral decompression via a unilateral approach for lumbar spinal canal stenosis including degenerative spondylolisthesis. J Neurosurg Spine. 2008;9:554–9.

    Article  PubMed  Google Scholar 

  21. Kelleher MO, Timlin M, Persaud O, Rampersaud YR. Success and failure of minimally invasive decompression for focal lumbar spinal stenosis in patients with and without deformity. Spine (Phila Pa 1976). 2010;35:E981–7.

    Article  PubMed  Google Scholar 

  22. Park JH, Hyun SJ, Roh SW, Rhim SC. A comparison of unilateral laminectomy with bilateral decompression and fusion surgery in the treatment of grade I lumbar degenerative spondylolisthesis. Acta Neurochir. 2012;154:1205–12.

    Article  PubMed  Google Scholar 

  23. Jang JW, Park JH, Hyun SJ, Rhim SC. Clinical outcomes and radiologic changes following microsurgical bilateral decompression via a unilateral approach in patients with lumbar canal stenosis and grade I degenerative spondylolisthesis with a minimum 3-year follow-up. J Spinal Disord Tech 2012 [Epub].

    Google Scholar 

  24. Wang S, Chao J, Wei J, Diaz FG. Short-term effectiveness of interlaminar lumbar instrumented fusion through a small incision for lumbar spinal stenosis. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2012;26:703–7.

    PubMed  Google Scholar 

  25. Martin CR, Gruszczynski AT, Braunsfurth HA, Fallatah SM, O’Neil J, Wai EK. The surgical management of degenerative lumbar spondylolisthesis: a systematic review. Spine (Phila Pa 1976). 2007;32:1791–8.

    Article  PubMed  Google Scholar 

  26. Rampersaud YR, Fisher C, Yee A, et al. Health-related quality of life following decompression compared to decompression and fusion for degenerative lumbar spondylolisthesis: a Canadian multicentre study. Can J Surg. 2014;57:E126–33.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Postacchini F, Postacchini R, Menchetti PP, Sessa P, Paolino M, Cinotti G. Lumbar interspinous process fixation and fusion with stand-alone interlaminar lumbar instrumented fusion implant in patients with degenerative spondylolisthesis undergoing decompression for spinal stenosis. Asian Spine J. 2016;10(1):27–37.

    Article  PubMed  PubMed Central  Google Scholar 

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Acknowledgments

The authors thank Giancarlo Guizzardi, MD, and Piero Petrini, MD, for making their patients’ medical records available for this retrospective study.

Conflicts of Interest

All the authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements) or nonfinancial interest (such as personal or professional relationships, affiliations, knowledge, or beliefs) in the subject matter or materials discussed in this manuscript.

Funding Disclosure

No funding was received for this research.

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Authors and Affiliations

  1. Division of Neurosurgery, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Università degli Studi di Napoli Federico II, Naples, Italy

    Giulia Guizzardi

  2. Orthopaedic and Traumatology Unit, Humanitas Mater Domini, Castellanza, Varese, Italy

    Carlo Antonio Todaro

  3. Neurosurgical Department 2, IRCCS Istituto Neurologico Mediterraneo, Pozzilli, Isernia, Italy

    Gualtiero Innocenzi

Authors
  1. Giulia Guizzardi
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  2. Carlo Antonio Todaro
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  3. Gualtiero Innocenzi
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Editor information

Editors and Affiliations

  1. Institute of Neurosurgery, Catholic University of Rome, Rome, Italy

    Massimiliano Visocchi

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Guizzardi, G., Todaro, C.A., Innocenzi, G. (2023). A New Interlaminar/Interspinous and Facet-Joint Stabilization System in Lumbar Degenerative Disk Disease: 2 Years of Results. In: Visocchi, M. (eds) The Funnel: From the Skull Base to the Sacrum. Acta Neurochirurgica Supplement, vol 135. Springer, Cham. https://doi.org/10.1007/978-3-031-36084-8_67

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  • DOI: https://doi.org/10.1007/978-3-031-36084-8_67

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-031-36083-1

  • Online ISBN: 978-3-031-36084-8

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