gms | German Medical Science

60th Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Benelux countries and Bulgaria

German Society of Neurosurgery (DGNC)

24 - 27 May 2009, Münster

Interspinous devices and the treatment of lumbar spinal canal stenosis – Is there a valid alternative or only supplement to established operative techniques?

Meeting Abstract

  • J. Gempt - Neurochirurgische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität, München
  • M. Stoffel - Neurochirurgische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität, München
  • N. Buchmann - Neurochirurgische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität, München
  • A. Grams - Abteilung für Neuroradiologie, Klinikum rechts der Isar, Technische Universität, München
  • B. Meyer - Neurochirurgische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität, München
  • C. Stüer - Neurochirurgische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität, München

Deutsche Gesellschaft für Neurochirurgie. 60. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit den Benelux-Ländern und Bulgarien. Münster, 24.-27.05.2009. Düsseldorf: German Medical Science GMS Publishing House; 2009. DocP11-05

doi: 10.3205/09dgnc368, urn:nbn:de:0183-09dgnc3688

Published: May 20, 2009

© 2009 Gempt et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

Text

Objective: Interspinous devices are increasingly used as an alternative and in addition to established operative therapy for lumbar spinal stenosis. Many different devices are in use. To date, the indication for interspinous devices and treatment outcome are still ambiguous.

Methods: 63 patients who had been treated with interspinous devices were identified retrospectively. 22 patients had received X-Stop, 25 InSpace and 17 Diam. Altogether, 99 implants were used. 46 Patients responded to our questionnaire concerning back and leg pain, walking distance, quality of life, ODI-Score.

Results: Mean follow-up was 8.26 months (range of 2 to 15 months). Mean age was 70 years (range 28 to 88 years). 25 patients received a decompression and interspinous device. Preoperative ODI score of all patients was 51.3%. The InSpace group improved most with an ODI decrease from 51.2 to 24.3% (p<0.05) and a quality of life increase from 31.3 to 64.3% (p<0.05). Back pain decreased from 5.8 to 2.9 (p<0.05), leg pain decreased from 4.4 to 2 (p<0.05). 8 Patients received additional decompression, stabilization or interspinous device explantation in a second operation. 7 of 8 patients who underwent a second operation had received decompression and an interspinous device during the first operation. Due to this fact a meaningful assessment of study parameters in these patients was not possible.

Conclusions: Patient group, therapy and outcome after treatment of lumbar spinal canal stenosis with interspinous devices are heterogeneous in clinical practice. Requirements for this treatment are: minimally-invasive, low complication rate, and good clinical outcome. We do not see these requirements completely fulfilled. Even the combination of decompression and use of an interspinous device impedes the evaluation of therapy outcome and increases complication rate. A significant reduction of back pain compared to other possible surgical treatments could not be disclosed either.