A Change in the Parameters of the Spine Following the Implantati on of a Lumbar Interspino us Spacer DIAM
Authors:
L. Hrabálek 1; J. Novotný 2; J. Koluchová 2; M. Vaverka 1; O. Kalita 1; K. Langová 3
Authors‘ workplace:
Ne urochirurgická klinika LF UP a FN Olomo uc, 2Radi ologické oddělení FN Olomo uc, 3Ústav lékařské biofyziky LF UP v Olomo uci
1
Published in:
Cesk Slov Neurol N 2009; 72/105(4): 337-342
Category:
Original Paper
Overview
One dynamic stabilizati on technique is the implantati on of an “interspino us spacer” between the spino us processes of the lumbar spine. The objective of this study was to verify whether, following implantati on of the DIAM interspino us spacer (Medtronic, USA), there was any space distracti on, whether the sagittal angle of the lumbar spine had changed and whether mobility of the operated segment was maintained. Pati ents suffering from degenerative lumbosacral spine dise ase due to a herni a of the disc or foraminostenosis and accompani ed by axi al pain and radicular symptoms, were indicated for the operati on. The pati ent gro up consisted of 17 pati ents (7 women and 10 men) in the age range of 23 to 66 (the average age was 45.58). Pri or to the operati on and one month following the operati on the pati ents assessed VAS for axi al and radicular pain and simultane o usly underwent a dynamic ski agram of the lumbosacral spine, a static ski agram of the lumbosacral spine pri or to the operati on and one week after, as well as undergo ing a CT examinati on me asuring the height of both intervertebral foramen and the back and front heights of the disc. Implantati on of the DIAM spacer ca used distracti on of the operated segment of the lumbar spine in the order of tenths of a millimeter, ca used lordotizati on of the lumbar spinal cord by 1.65° on average and maintained the mobility of the operated segment with an average range of 11.38°. The average VAS for axi al pain improved from 5.7 to 0.47 po ints and from 5.9 to 0.41 for radicular pain. The low “intra‑observer” and “inter‑observer” vari ability of repe ated me asurements of the heights was demonstrated by CT scan. In conclusi on, the a uthors state that the DIAM spacer ca uses only slight distracti on of the entire operated segment of the lumbar spine on average; for this re ason it is impossible to rely on the effect of indirect decompressi on on exiting nerve ro ots. The implant can ca use kyphotizati on of the spine and therefore, the use of interspino us spacers in those pati ents demonstrating pre‑operative signs of kyphosis of the operated segment must be seri o usly considered beforehand.
Key words:
low back pain – implants – dynamic spine stabilization
Sources
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Paediatric neurology Neurosurgery NeurologyArticle was published in
Czech and Slovak Neurology and Neurosurgery
2009 Issue 4
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