An Official publication of The Asian Congress of Neurological Surgeons (AsianCNS)

Search Article
Home About us Editorial board Search Ahead of print Current issue Archives Submit article Instructions Advertise Subscribe Contacts Login  Facebook Tweeter
  Users Online: 74 Home Print this page Email this page Small font sizeDefault font sizeIncrease font size  
 
ORIGINAL ARTICLE
Ahead of Print

Posterior dynamic stabilization: The interspinous spacer from treatment to prevention


 Department of Neurosurgery, Saint George Hospital University Medical Center in Collaboration with Balamand University, Beirut, P.O Box 166378, Lebanon

Correspondence Address:
Antoine Nachanakian,
Department of Neurosurgery, Saint George Hospital University Medical Center in Collaboration with Balamand University, Beirut, P.O Box 166378
Lebanon
Login to access the Email id

Source of Support: None, Conflict of Interest: None

Introduction: Managements of lumbar stenosis evoluted over the time from decompression to dynamic stabilization preserving the motion segment passing by the rigid fixation. After long years of rigid fusion, adjacent segment disease became more and more frequent and the concept of dynamic stabilization emerged. Materials and Methods: We report our experience with posterior dynamic stabilization using an interspinous distracter (ISD). One hundred and eight patients were operated between September 2008 and January 2012 with different lumbar spine pathologies. The ages of our patients were between 45 years and 70 years, with a mean age of 55 years. With our growing experience, indication of ISD became narrowed and the interspinous spacer became an absolute tool for adjacent segment disease as a treatment as well as prophylactic with rigid stabilization. Results and Discussion: Overall clinical improvement was noted in ISD-treated patients, with considerable satisfaction in 77% of patients on average. The patient at first reported an improvement of their radicular pain with a mean reduction of 3.6/10 on visual analog scale. Post-operative walking distance progressively increased during the next 3 months. Whereas, a radiological evaluation at 3 months showed a mean of 42% improvement of the disc height. On the other hand, all patients operated with posterior dynamic stabilization (PDS) at the time of rigid stabilization showed no adjacent segment disease compared to those operated with posterior arthrodesis (P < 0.05). Conclusion: Interspinous spacer after surgical decompression for spinal stenosis by excision of Ligamentum flavum demonstrates excellent short-term and long-term results for improvement in back pain, neurogenic claudication, and patient satisfaction. It provides restoration of disc height, reduction of vertebral slip and it's a necessary tool in the management and the prevention of adjacent segment disease.


Print this article
Search
 Back
 
  Search Pubmed for
 
    -  Nachanakian A
    -  El Helou A
    -  Alaywan M
 Citation Manager
 Article Access Statistics
 Reader Comments
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed814    
    PDF Downloaded23    

Recommend this journal