Skip to main content
SpringerLink
Log in

Interspinous Process Implant for Treatment of Lateral and Central Spinal Stenosis

Operative Technique and Results

  • Chapter
Arthroscopic and Endoscopic Spinal Surgery

  • 879 Accesses

Abstract

The clinical syndrome of spinal stenosis is usually seen in middle-aged or elderly individuals who complain of leg pain, weakness, paresthesia, or sensory changes that generally develop on standing or walking and are relieved, typically, by sitting and lying down. Often patients stoop forward to ease the symptoms when standing or walking. The condition can be extremely disabling, making the sufferer, in many cases, housebound.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Sachs B, Frankel V. Progressive and kyphotic rigidity of the spine. J Nerv Ment Dis 1900;27:1.

    Google Scholar 

  2. Putti V. Lady Jones lecture: on new concepts on the pathogenesis of sciatic pain. Lancet 1927;210(5491):53–60.

    Article  Google Scholar 

  3. Hirsch C. On lumbar pacetectomies. Acta Orthop Scand 1948;17:240–252.

    PubMed  CAS  Google Scholar 

  4. Harris RI, MacNab I. Structural changes in the lumbar intervertebral discs: their relation ship to low back pain and sciatica. J Bone Joint Surg 1954;386:304–322.

    Google Scholar 

  5. MacNab I. Negative disc exploration. J Bone Joint Surg 1971;53A:891–903.

    Google Scholar 

  6. Verbiest H. Neurogenic intermittent claudication in cases with absolute and relative steno sis of the lumbar vertebral canal (ASLC and RSLC), in cases with narrow lumbar intervertebral foramina, and in cases with both entities. Clin Neurosurg 1973;20:204–214.

    PubMed  CAS  Google Scholar 

  7. Verbiest H. Results of surgical treatment of idiopathic developmental stenosis of the lumbar vertebral canal: a review of twenty-seven years’ experience. J Bone Joint Surg 1977;59B(2).

    Google Scholar 

  8. Verbiest H. Stenosis of the lumbar vertebral canal and sciatica. Neurosurg Rev 1980;3:75–89.

    Article  PubMed  CAS  Google Scholar 

  9. Verbiest H. The treatment of lumbar spondyloptosis or impending lumbar spondyloptosis accompanied by neurologic deficit and/or neurogenic intermittent claudication. Spine 1979;4:68–77.

    Article  PubMed  CAS  Google Scholar 

  10. Porter RW. Variations in shape and size of the lumbar spinal canal. Paleopathol Newsle 1980;32:9–11.

    CAS  Google Scholar 

  11. Eisenstein S. The morphometry and pathological anatomy of the lumbar spine in South African Negroes and Caucasoids with special reference to spinal stenosis. J Bone Joint Surg 1977;59B:172–180.

    Google Scholar 

  12. Porter RW, Wicks M, Ottwell D. Measurement of the spinal canal by diagnostic ultrasound. J Bone Joint Surg (Br) 1978;60B(4):481–484.

    Google Scholar 

  13. Kadziolka R, AszteIy M, Hanai K, Hansson T, Nachemson A. Ultrasonic measurement of the lumbar spinal canal: the origin and precision of the recorded echoes. J Bone Joint Surg 1981;63B(4):504–507.

    CAS  Google Scholar 

  14. Porter RW, Hibbert CS, Wicks M. The spinal canal in symptomatic lumbar disc lesions. J Bone Joint Surg (Br) 1978;60B(4):485–487.

    Google Scholar 

  15. Papp T, Porter RW, Aspden RM. The growth of the lumbar vertebral canal. Spine 1994;19(24):2770–2773.

    Article  PubMed  CAS  Google Scholar 

  16. Papp T, Porter RW, Aspden RM. Trefoil configuration and developmental stenosis of the lumbar vertebral canal. J Bone Joint Surg (Br) 1995;77B:469–472.

    Google Scholar 

  17. Arnoldi CC, Brodsky AE, Cauchoix J, et al. Lumbar spinal stenosis and nerve root entrapment syndromes: definition and classification. Clin Orthop 1976;(115):4–5.

    Google Scholar 

  18. Hawkes CH, Roberts GM. Neurogenic and vascular claudication. J Neurol Sci 1978;38:337–345.

    Article  PubMed  CAS  Google Scholar 

  19. Salibi BS. Neurogenic intermittent claudication and stenosis of the lumbar spinal canal. Surg Neurol 1976;5:269–272.

    PubMed  CAS  Google Scholar 

  20. Cinotti, G, De Santis P, Nofroni I, Postacchini F. Stenosis of lumbar intervertebral fora men: anatomic study on predisposing factors. Spine 2002;27(3):223–229.

    Article  PubMed  Google Scholar 

  21. Panjabi MM, Takata K, Goel VK. Kinematics of lumbar intervertebral foramen. Spine 1983;8:348–357.

    Article  PubMed  CAS  Google Scholar 

  22. Araksinen O, Herno A, Turunen V, Saari T, Suomlainen O. Degenerative spondylolisthesis: surgical outcome of 438 patients treated surgically for lumbar spinal stenosis. Spine 1997;22:2278–2282.

    Article  Google Scholar 

  23. Amundsen T, Weber H, Nordal HJ, Hele J, Magnaes B, Adelnoor MMPH, Lilleas F. Lumbar spinal stenosis: conservative or surgical management? a prospective 10 year study. Spine 2000;25:1424–1436.

    Article  PubMed  CAS  Google Scholar 

  24. Herkowitz HN, Kurz LT. Degenerative lumbar spondylolisthesis with spinal stenosis. J Bone Joint Surg (Am) 1991;73:802–807.

    CAS  Google Scholar 

  25. Mardjetko SM, Connolly PJ, Short S. Degenerative lumbar spondylolisthesis: a meta analysis of literature 1970–1993. Spine 1994;19:2257S–2265S.

    Article  Google Scholar 

  26. Crock HV. Normal and pathological anatomy of the lumbar spinal nerve root canals. J Bone Joint Surg (Br) 1981;63:487–490.

    Google Scholar 

  27. Adams MA, May S, Freeman BJ, et al. Effects of backward bending on lumbar intervertebral discs: relevance to physical therapy treatments for low back pain. Spine 2000;25:431–437: discussion, 438.

    Article  PubMed  CAS  Google Scholar 

  28. Chung SS, Lee CS, Kim SH, et al. Effect of low back posture on the morphology of the spinal canal. Skeletal Radiol 2000;29:217–223.

    Article  PubMed  CAS  Google Scholar 

  29. Rauschning W. Normal and pathologic anatomy of the lumbar root canals. Spine 1987;12:1008–1019.

    Article  PubMed  CAS  Google Scholar 

  30. Postacchini F, Cinotti G. Bone regrowth after surgical decompression for lumbar spinal stenosis. J Bone Joint Surg (Br) 1992;74:862–869.

    CAS  Google Scholar 

  31. Amundsen T, Weber H, Lilleas F, et al. Lumbar spinal stenosis: clinical and radiologic features. Spine 1995;20:1178–1186.

    Article  PubMed  CAS  Google Scholar 

  32. Keenan GF, Ashcroft GP, Roditi GH, et al. Measurement of lower limb blood flow in patients with neurogenic claudication using positron emission tomography. Spine 1995;20(4):408–411.

    PubMed  CAS  Google Scholar 

  33. Naylor A. Factors in the development of the spinal stenosis syndrome. J Bone Joint Surg (Br) 1979;61B(3):306–309.

    Google Scholar 

  34. Porter RW. Spinal stenosis and neurogenic claudication. Spine 1996;21:2046–2052.

    Article  PubMed  CAS  Google Scholar 

  35. Schmid MR, Stucki G, Duewell S, et al. Changes in cross-sectional measurements of the spinal canal and intervertebral foramina as a function of body position: in vivo studies on an open-configuration MR system. Am J Roentgenol 1999;172:1095–1102.

    CAS  Google Scholar 

  36. Fujiwara A, An HS, Lim TH, et al. Morphologic changes in the lumbar intervertebral fora men due to flexion-extension, lateral bending, and axial rotation an in vitro anatomic and biomechanical study. Spine 2001;26:876–882.

    Article  PubMed  CAS  Google Scholar 

  37. Inufusa A, An HS, Lim TH, et al. Anatomic changes of the spinal canal and intervertebral foramen associated with flexion-extension movement. Spine 1996;21:2412–2420.

    Article  PubMed  CAS  Google Scholar 

  38. Penning L, Wilmink JT. Posture-dependent bilateral compression of L4 or L5 nerve roots in facet hypertrophy: a dynamic CT-myelographic study. Spine 1987;12:488–500.

    Article  PubMed  CAS  Google Scholar 

  39. Rothman SL. Dynamic effect on the lumbar spinal canal. Spine 1998;23:1506, 1507.

    Google Scholar 

  40. Vitzthum HE, Konig A, Seifert V. Dynamic examination of the lumbar spine by using vertical, open magnetic resonance imaging. J Neurosurg 2000;93:58–64.

    PubMed  CAS  Google Scholar 

  41. Wildermuth S, Zanetti M, Duewell S, et al. Lumbar spine: quantitative and qualitative assessment of positional (upright flexion and extension) MR imaging and myelography. Radiology 1998;207:391–398.

    PubMed  CAS  Google Scholar 

  42. Dyck P. The Stoop test in lumbar entrapment radiculopathy. Spine 1979;4:89–92.

    Article  PubMed  CAS  Google Scholar 

  43. Aryanpur J, Ducker T. Multilevel lumbar laminotomies: an alternative to laminectomy in the treatment of lumbar stenosis. Neurosurgery 1990;26:429–433.

    Article  PubMed  CAS  Google Scholar 

  44. Cinotti G, Postacchini F, Weinstein JN. Lumbar spinal, stenosis and diabetes: outcome of surgical decompression. J Bone Joint Surg (Br) 1994;76:215–219.

    CAS  Google Scholar 

  45. Getty CJM. Lumbar spinal stenosis: the clinical spectrum and results of operations. J Bone Joint Surg (Br) 1980;62:481–485.

    Google Scholar 

  46. Grob D, Humke T, Dvorak J. Degenerative lumbar spinal stenosis: decompression with and without arthrodesis. J Bone Joint Surg (Am) 1995;77:1036–1041.

    CAS  Google Scholar 

  47. Herno A, Airaksinen O, Saari T. Long-term results of surgical treatment of lumbar spinal stenosis. Spine 1993;18:1471–1474.

    Article  PubMed  CAS  Google Scholar 

  48. Herron LD, Mangelsdorf C. Lumbar spinal stenosis. J Spinal Disord 1991;4:26–33.

    PubMed  CAS  Google Scholar 

  49. Hilibrand AS, Rand N. Degenerative lumbar stenosis: diagnosis and management. J Am Acad Orthop Surg 1999;7:239–249.

    PubMed  CAS  Google Scholar 

  50. Jonsson B, Annertz M, Sioberg C, et al. A prospective and consecutive study of surgically treated lumbar spinal stenosis. Part II: five-year follow-up by an independent observer. Spine 1997;22:2938–2944.

    Article  PubMed  CAS  Google Scholar 

  51. Jonsson B, Stromqvist B, Decompression for lateral lumbar stenosis: results and impact on sick leave and working conditions. Spine 1994;19:2381–2386.

    PubMed  CAS  Google Scholar 

  52. Katz JN, Lipson SJ, Chang LC, et al. Seven to 10-year outcome of decompressive surgery for degenerative lumbar spinal stenosis. Spine 1996;21:92–98.

    Article  PubMed  CAS  Google Scholar 

  53. Katz JN, Lipson SJ, Larson MG, et al. The outcome of decompressive laminectomy for degenerative lumbar stenosis. J Bone Joint Surg (Am) 1991;73:809–816.

    CAS  Google Scholar 

  54. Katz JN, Lipson SJ, Larson MG, Mclnnes JM, Fossel AH, Liang MH. The outcome of decompressive laminectomy for degenerative lumbar spinal stenosis. J Bone Joint Surg (Am) 1991;73:809–813.

    CAS  Google Scholar 

  55. Postacchini F, Cinotti G, Gumina S, et al. Long-term results of surgery in lumbar stenosis: 8-year review of 64 patients. Acta Orthop Scand 1993;64 78–80.

    Google Scholar 

  56. Postacchini F, Cinotti G, Perugia D, et al. The surgical treatment of central lumbar stenosis: multiple laminotomy compared with total laminectomy. J Bone Joint Surg (Br) 1993;75:386–392.

    CAS  Google Scholar 

  57. Postacchini F. Surgical management of lumbar spinal stenosis. Spine 1999;24:1043–1047.

    Article  PubMed  CAS  Google Scholar 

  58. Chen O, Baba H, Kamitani K, et al. Postoperative bone re-growth in lumbar spinal stenosis: a multivariate analysis of 48 patients. Spine 1994;19:2144–2149.

    Article  PubMed  CAS  Google Scholar 

  59. Chow DH, Luk KD, Evans JH, et al. Effects of short anterior lumbar interbody fusion on biomechanics of neighboring unfused segments. Spine 1996;21:549–555.

    Article  PubMed  CAS  Google Scholar 

  60. Cunningham BW, Kotani Y, McNulty PS, et al. The effect of spinal destabilization and instrumentation on lumbar intradiscal pressure: an in vitro biomechanical analysis. Spine 1997;22:2655–2663.

    Article  PubMed  CAS  Google Scholar 

  61. Ha KY, Schendel MJ, Lewis JL, et al. Effect of immobilization and configuration on lumbar adjacent-segment biomechanics. J Spinal Disord 1993;6:99–105.

    Article  PubMed  CAS  Google Scholar 

  62. Kim YE, Goel VK, Weinstein JN, et al. Effect of disc degeneration at one level on the adjacent level in axial mode. Spine 1991;16:331–335.

    Article  PubMed  CAS  Google Scholar 

  63. Marchesi DG, Aebi M. Pedicle fixation devices in the treatment of adult lumbar scoliosis. Spine 1992;17:S304–S309.

    Article  PubMed  CAS  Google Scholar 

  64. Rohlmann A, Calisse J, Bergmann G, et al. Internal spinal fixator stiffness has only a minor influence on stresses in the adjacent discs. Spine 1999;24:1192–1195.

    Article  PubMed  CAS  Google Scholar 

  65. Rohlmann A, Neller S, Bergmann G, et al. Effect of an internal fixator and a bone graft on intersegmental spinal motion and intradiscal pressure in the adjacent regions. Eur Spine J 2001;10:301–308.

    Article  PubMed  CAS  Google Scholar 

  66. Weinhoffer SL, Guyer RD, Herbert M, et al. Intradiscal pressure measurements above an instrumented fusion: a cadaveric study. Spine 1995;20:526–531.

    Article  PubMed  CAS  Google Scholar 

  67. Aota Y, Kumano K, Hirabayashi S. Postfusion instability at the adjacent segments after rigid pedicle screw fixation for degenerative lumbar spinal disorders. J Spinal Disord 1995;8:464–473.

    Article  PubMed  CAS  Google Scholar 

  68. Etebar S, Cahill DW. Risk factors for adjacent-segment failure following lumbar fixation with rigid instrumentation for degenerative instability. J Neurosurg 1999;90:163–169.

    PubMed  CAS  Google Scholar 

  69. Frymoyer JW, Hanley EN Jr, Howe J, et al. A comparison of radiographic findings in fusion and nonfusion patients ten or more years following lumbar disc surgery. Spine 1979;4:435–440.

    Article  PubMed  CAS  Google Scholar 

  70. Guigui P, Lambert P, Lassale B, et al. Long-term outcome at adjacent levels of lumbar arthrodesis. Rev Chir Orthop Reparatrice Appar Mot 1997;83:685–696.

    PubMed  CAS  Google Scholar 

  71. Kumar MN, Baklanov A, Chopin D, Correlation between sagittal plane changes and adjacent segment degeneration following lumbar spine fusion. Eur Spine J 2001;10:314–319.

    Article  PubMed  CAS  Google Scholar 

  72. Kumar MN, Jacquot F, Hall H. Long-term follow-up of functional outcomes and radio graphic changes at adjacent levels following lumbar spine fusion for degenerative disc disease. Eur Spine J 2001;10:309–313.

    Article  PubMed  CAS  Google Scholar 

  73. Lee CK. Accelerated degeneration of the segment adjacent to a lumbar fusion. Spine 1988;13:375–377.

    Article  PubMed  CAS  Google Scholar 

  74. Lehmann TR, Spratt KF, Tozzi JE, et al. Long-term follow-up of lower lumbar fusion patients. Spine 1987;12:97–104.

    Article  PubMed  CAS  Google Scholar 

  75. Miyakoshi N, Abe E, Shimada Y, et al. Outcome of one-level posterior lumbar interbody fusion for spondylolisthesis and postoperative intervertebral disc degeneration adjacent to the fusion. Spine 2000;25:1837–1842.

    Article  PubMed  CAS  Google Scholar 

  76. Nagata H, Schendel MJ, Transfeldt EE, et al. The effects of immobilization of long segments of the spine on the adjacent and distal facet force and lumbosacral motion. Spine 1993;18:2471–2479.

    Article  PubMed  CAS  Google Scholar 

  77. Schlegel JD, Smith JA, Schleusener RL. Lumbar motion segment pathology adjacent to thoracolumbar, lumbar, and lumbosacral fusions. Spine 1996;21:970–981.

    Article  PubMed  CAS  Google Scholar 

  78. Shono Y, Kaneda K, Abumi K, et al. Stability of posterior spinal instrumentation and its effects on adjacent motion segments in the lumbosacral spine. Spine 1998;23:1550–1558.

    Article  PubMed  CAS  Google Scholar 

  79. Van Horn JR, Bohnen LM. The development of discopathy in lumbar discs adjacent to a lumbar anterior interbody spondylodesis: a retrospective matched-pair study with a postoperative follow-up of 16 years. Acta Orthop Belg 1992;58:280–286.

    PubMed  Google Scholar 

  80. Whitecloud TS III, Davis JM, Olive PM. Operative treatment of the degenerated segment adjacent to a lumbar fusion. Spine 1994;19:531–536.

    PubMed  Google Scholar 

  81. Askar Z, Wardlaw D, Choudhary S, Rege A. A ligamentum flavum-preserving approach to the lumbar spinal canal. Spine 2003;28(19):E385–E390.

    Article  PubMed  Google Scholar 

  82. Reeg SE. A review of comorbidities and spinal surgery. Clin Orthop 2001;384:101–109.

    Article  PubMed  Google Scholar 

  83. Zucherman JF, Hsu KY, Hartjen CA, et al. 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 2004;13:22–31.

    Article  PubMed  CAS  Google Scholar 

  84. Swanson KE, Lindsey DP, Hsu KY, Zucherman JF, Yerby SA. The effects of an interspinous implant on intervertebral disc pressure. Spine 2003;28(l):26–32.

    Article  PubMed  Google Scholar 

  85. Lindsey DP, Swanson KF, 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 28:2192–2197.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Grampion University Hospitals Trust-Woodend Hospital, Aberdeen, Scotland

    Douglas Wardlaw ChM, FRCSEd (Consultant, and Orthopaedic and Spinal Surgeon)

Authors
  1. Douglas Wardlaw ChM, FRCSEd
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Drexel University College of Medicine, Philadelphia, PA

    Parviz Kambin MD (Professor Orthopedic Surgery and Endowed Chair of Spinal Surgery) (Professor Orthopedic Surgery and Endowed Chair of Spinal Surgery)

Rights and permissions

Reprints and permissions

Copyright information

© 2005 Humana Press Inc., Totowa, NJ

About this chapter

Cite this chapter

Wardlaw, D. (2005). Interspinous Process Implant for Treatment of Lateral and Central Spinal Stenosis. In: Kambin, P. (eds) Arthroscopic and Endoscopic Spinal Surgery. Humana Press. https://doi.org/10.1385/1-59259-904-4:315

Download citation

  • DOI: https://doi.org/10.1385/1-59259-904-4:315

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-58829-522-4

  • Online ISBN: 978-1-59259-904-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation