Abstract
Introduction
Insertion of an interspinous device has become a common procedure for the treatment of different clinical pictures of degenerative spinal disease. We present our experience with patients treated with interspinous devices because affected by claudication neurogenic, by lumbar disk herniation (LDH) where the interspinous system has been inserted following microdiscectomy.
Materials and Methods
This study included patients (n = 200) with neurogenic intermittent claudication (NIC) secondary to LSS (group 1) and patients (n = 150) with LDH (group 2) in whom the interspinous device has been implanted following radicular decompression in a period spanning 6 years. The latter have been compared with a homogenous group of patients (n = 150) where no interspinous system has been implanted following microdiscectomy (group 3). We observed clinical and neuroradiological findings preoperatively and 3, 6, 12 months and every year postoperatively using dedicated questionnaires (Zurich Claudication Questionnaire, SF-36, ODI) and X-ray imaging.
Results
After 6 years of surgical treatment 85% of patients of group 1 presented a very good improvement of symptoms and 90% of patients referred satisfaction for surgery. Only 2% of the cases needed re-operation to change the implant. In one case the device was removed and in two cases we observed recurrence of symptoms and we changed surgical procedure. Overall patients of group 2 presented significantly less lumbar disk recurrences compared with group 3 (p < 0.05) and better clinical outcome when compared with the same group (p < 0.01).
Conclusion
According to our features, no significant complications were associated with such kind of surgery. In particular, interspinous systems showed significant and clinically meaningful improvements in pain and disability for up to 6 years. Furthermore, interspinous devices have shown better clinical outcome and less lumbar disk recurrences when associated with standard microdiscectomy. These data, however, need further studies and a longer period of follow-up.
No
None declared