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Perspective: Efficacy and outcomes for different lumbar interspinous devices (ISD) vs. open surgery to treat lumbar spinal stenosis (LSS) – Lumbar Spinal Stenosis

The article discusses the use of interspinous devices (ISD) as a minimally invasive alternative to open surgery for treating lumbar spinal stenosis (LSS). ISD devices help offload pressure on the disc space, increase intervertebral foraminal/disc space heights, stabilize the surgical level, and reduce adjacent segment disease (ASD). The study compares the efficacy and outcomes of various ISD devices with open surgery and finds that newer generation devices provide the greatest reductions in cost-saving parameters such as operative time, length of hospital stay, and reoperation rates. Additionally, the study shows that the average cost of new generation ISD/decompressions is significantly lower compared to open surgery. Overall, patients undergoing new generation ISD for LSS showed comparable or better outcomes with greater reductions in various parameters compared to those receiving older ISD devices or open surgery

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : finest spine centre in UK

Published article

CONCLUSION: Patients undergoing new generation ISD for LSS exhibited comparable or better outcomes, but greater reductions in OR times, EBL, LOS, ROM, and ASD vs. those receiving original/current ISD or undergoing open surgery.

Lumbar Decompression Surgery Expert. Best Spinal Surgeon UK
Surg Neurol Int. 2024 Jan 19;15:17. doi: 10.25259/SNI_1007_2023. eCollection 2024.ABSTRACTBACKGROUND: Interspinous devices (ISD) constitute a minimally invasive (MI) alternative to open surgery (i.e., laminectomy/decompression with/without fusion (i.e., posterior lumbar interbody fusion (PLIF)/posterolateral instrumented fusion (PLF)) for treating lumbar spinal stenosis (LSS). Biomechanically, static and/or dynamic ISD “offload” pressure on the disc space, increase intervertebral foraminal/disc,

Surg Neurol Int. 2024 Jan 19;15:17. doi: 10.25259/SNI_1007_2023. eCollection 2024.

ABSTRACT

BACKGROUND: Interspinous devices (ISD) constitute a minimally invasive (MI) alternative to open surgery (i.e., laminectomy/decompression with/without fusion (i.e., posterior lumbar interbody fusion (PLIF)/posterolateral instrumented fusion (PLF)) for treating lumbar spinal stenosis (LSS). Biomechanically, static and/or dynamic ISD “offload” pressure on the disc space, increase intervertebral foraminal/disc space heights, reverse/preserve lordosis, limit range of motion (ROM)/stabilize the surgical level, and reduce adjacent segment disease (ASD). Other benefits reported in the literature included; reduced operative time (OR Time), length of hospital stay (LOS), estimated blood loss (EBL), and improved outcomes (i.e., ODI (Oswestry Disability Index), VAS (Visual Analog Scale), and/or SF-36 (Short-Form 36)).

METHODS: Various studies documented the relative efficacy and outcomes of original (i.e., Wallis), current (i.e., X-STOP, Wallis, DIAM, Aperius PercLID), and new generation (i.e., Coflex, Superion Helifix, In-Space) ISD used to treat LSS vs. open surgery.

RESULTS: Although ISD overall resulted in comparable or improved outcomes vs. open surgery, the newer generation ISD provided the greatest reductions in critical cost-saving parameters (i.e., OR time, LOS, and lower reoperation rates of 3.7% for Coflex vs. 11.1% for original/current ISD) vs. original/current ISD and open surgery. Further, the 5-year postoperative study showed the average cost of new generation Coflex ISD/decompressions was $15,182, or $11,681 lower than the average $26,863 amount for PLF.

CONCLUSION: Patients undergoing new generation ISD for LSS exhibited comparable or better outcomes, but greater reductions in OR times, EBL, LOS, ROM, and ASD vs. those receiving original/current ISD or undergoing open surgery.

PMID:38344078 | PMC:PMC10858763 | DOI:10.25259/SNI_1007_2023

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Perspective: Efficacy and outcomes for different lumbar interspinous devices (ISD) vs. open surgery to treat lumbar spinal stenosis (LSS)

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Surg Neurol Int. 2024 Jan 19;15:17. doi: 10.25259/SNI_1007_2023. eCollection 2024.ABSTRACTBACKGROUND: Interspinous devices (ISD) constitute a minimally invasive (MI) alternative to open surgery (i.e., laminectomy/decompression with/without fusion (i.e., posterior lumbar interbody fusion (PLIF)/posterolateral instrumented fusion (PLF)) for treating lumbar spinal stenosis (LSS). Biomechanically, static and/or dynamic ISD "offload" pressure on the disc space, increase intervertebral foraminal/disc

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