Interspinous Process Devices Do Not Reduce Intervertebral Foramina and Discs Heights on Adjacent Segments
Mateusz Krakowiak,1 Natalia Rulewska,2 Marcin Rudaś,1 Maciej Broda,1 Michał Sabramowicz,1 Andrzej Jaremko,1 Krzysztof Leki,3 Paweł Sokal1 1Department of Neurosurgery and Neurology, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland; 2Students’ Scien...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Dove Medical Press
2022-07-01
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| Series: | Journal of Pain Research |
| Subjects: | |
| Online Access: | https://www.dovepress.com/interspinous-process-devices-do-not-reduce-intervertebral-foramina-and-peer-reviewed-fulltext-article-JPR |
| _version_ | 1818534684990111744 |
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| author | Krakowiak M Rulewska N Rudaś M Broda M Sabramowicz M Jaremko A Leki K Sokal P |
| author_facet | Krakowiak M Rulewska N Rudaś M Broda M Sabramowicz M Jaremko A Leki K Sokal P |
| author_sort | Krakowiak M |
| collection | DOAJ |
| description | Mateusz Krakowiak,1 Natalia Rulewska,2 Marcin Rudaś,1 Maciej Broda,1 Michał Sabramowicz,1 Andrzej Jaremko,1 Krzysztof Leki,3 Paweł Sokal1 1Department of Neurosurgery and Neurology, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland; 2Students’ Scientific Circle at the Department of Neurosurgery, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland; 3Centre for Statistical Analysis, Nicolaus Copernicus University, Toruń, PolandCorrespondence: Paweł Sokal, Department of Neurosurgery and Neurology, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland, Tel/Fax +48 523655505, Email pawel.sokal@cm.umk.plAim: Interspinous process device (IPD) placement is an attractive treatment option for lumbar spinal and foraminal stenosis. The goal of the treatment is to release the stress on facets joints as well as decompress the nerve roots by enlarging the intervertebral foramina and narrowed canal recesses.Purpose: To evaluate possible structural changes in the lumbar spine after implantation of an IPD on operated and adjacent segments.Patients and Methods: Twenty-two patients were enrolled in the study. Preoperative MRI scans of the lumbar spine evaluated recess and foraminal stenosis prior to the application of an IPD. CT exams were performed and morphometric measurements were made to assess the size of intervertebral foramina after implantation on the operated and adjacent segments.Results: Statistically significant enlargements in diameter and surface area of the intervertebral foramen were seen at the operating level. On the right and left sides, foraminal enlargement after the procedure was 1 mm in diameter. The average enlargement of the foramina surface area at the level of implantation was 10 mm2. The median interspinous distance was significantly enlarged by 3.5 mm. No significant changes in adjacent segments were observed. Clinical improvement was confirmed by the Oswestry Disability Index (ODI) and visual analog scale (VAS). Preoperative disability was reduced (mean ODI from 70.5 (12.25) to 49.5 (23.75)), as well as back pain (mean VAS from 8.0 (1.7) to 4.4 (2.6)) and pain in lower limbs (mean VAS from 7.4 (1.9) to 3.8 (2.9)).Conclusion: Decompression surgery using an IPD is effective in the treatment of lumbar foraminal and canal stenosis. It provides relief of symptoms in short-term observation through enlargement of intervertebral foramina and decompression of neural roots. It reduces overload of facet joints of the operated segment and does not decrease the size of the intervertebral foramina and disc heights of adjacent segments.Keywords: interspinous device, low lumbar back pain, lumbar decompression, spinal canal stenosis, foraminal stenosis |
| first_indexed | 2024-12-11T18:14:46Z |
| format | Article |
| id | doaj.art-dc3028766d14487aa34af87b10582230 |
| institution | Directory Open Access Journal |
| issn | 1178-7090 |
| language | English |
| last_indexed | 2024-12-11T18:14:46Z |
| publishDate | 2022-07-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Journal of Pain Research |
| spelling | doaj.art-dc3028766d14487aa34af87b105822302022-12-22T00:55:28ZengDove Medical PressJournal of Pain Research1178-70902022-07-01Volume 151971198276580Interspinous Process Devices Do Not Reduce Intervertebral Foramina and Discs Heights on Adjacent SegmentsKrakowiak MRulewska NRudaś MBroda MSabramowicz MJaremko ALeki KSokal PMateusz Krakowiak,1 Natalia Rulewska,2 Marcin Rudaś,1 Maciej Broda,1 Michał Sabramowicz,1 Andrzej Jaremko,1 Krzysztof Leki,3 Paweł Sokal1 1Department of Neurosurgery and Neurology, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland; 2Students’ Scientific Circle at the Department of Neurosurgery, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland; 3Centre for Statistical Analysis, Nicolaus Copernicus University, Toruń, PolandCorrespondence: Paweł Sokal, Department of Neurosurgery and Neurology, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland, Tel/Fax +48 523655505, Email pawel.sokal@cm.umk.plAim: Interspinous process device (IPD) placement is an attractive treatment option for lumbar spinal and foraminal stenosis. The goal of the treatment is to release the stress on facets joints as well as decompress the nerve roots by enlarging the intervertebral foramina and narrowed canal recesses.Purpose: To evaluate possible structural changes in the lumbar spine after implantation of an IPD on operated and adjacent segments.Patients and Methods: Twenty-two patients were enrolled in the study. Preoperative MRI scans of the lumbar spine evaluated recess and foraminal stenosis prior to the application of an IPD. CT exams were performed and morphometric measurements were made to assess the size of intervertebral foramina after implantation on the operated and adjacent segments.Results: Statistically significant enlargements in diameter and surface area of the intervertebral foramen were seen at the operating level. On the right and left sides, foraminal enlargement after the procedure was 1 mm in diameter. The average enlargement of the foramina surface area at the level of implantation was 10 mm2. The median interspinous distance was significantly enlarged by 3.5 mm. No significant changes in adjacent segments were observed. Clinical improvement was confirmed by the Oswestry Disability Index (ODI) and visual analog scale (VAS). Preoperative disability was reduced (mean ODI from 70.5 (12.25) to 49.5 (23.75)), as well as back pain (mean VAS from 8.0 (1.7) to 4.4 (2.6)) and pain in lower limbs (mean VAS from 7.4 (1.9) to 3.8 (2.9)).Conclusion: Decompression surgery using an IPD is effective in the treatment of lumbar foraminal and canal stenosis. It provides relief of symptoms in short-term observation through enlargement of intervertebral foramina and decompression of neural roots. It reduces overload of facet joints of the operated segment and does not decrease the size of the intervertebral foramina and disc heights of adjacent segments.Keywords: interspinous device, low lumbar back pain, lumbar decompression, spinal canal stenosis, foraminal stenosishttps://www.dovepress.com/interspinous-process-devices-do-not-reduce-intervertebral-foramina-and-peer-reviewed-fulltext-article-JPRinterspinous devicelow lumbar back painlumbar decompressionspinal canal stenosisforaminal stenosis. |
| spellingShingle | Krakowiak M Rulewska N Rudaś M Broda M Sabramowicz M Jaremko A Leki K Sokal P Interspinous Process Devices Do Not Reduce Intervertebral Foramina and Discs Heights on Adjacent Segments Journal of Pain Research interspinous device low lumbar back pain lumbar decompression spinal canal stenosis foraminal stenosis. |
| title | Interspinous Process Devices Do Not Reduce Intervertebral Foramina and Discs Heights on Adjacent Segments |
| title_full | Interspinous Process Devices Do Not Reduce Intervertebral Foramina and Discs Heights on Adjacent Segments |
| title_fullStr | Interspinous Process Devices Do Not Reduce Intervertebral Foramina and Discs Heights on Adjacent Segments |
| title_full_unstemmed | Interspinous Process Devices Do Not Reduce Intervertebral Foramina and Discs Heights on Adjacent Segments |
| title_short | Interspinous Process Devices Do Not Reduce Intervertebral Foramina and Discs Heights on Adjacent Segments |
| title_sort | interspinous process devices do not reduce intervertebral foramina and discs heights on adjacent segments |
| topic | interspinous device low lumbar back pain lumbar decompression spinal canal stenosis foraminal stenosis. |
| url | https://www.dovepress.com/interspinous-process-devices-do-not-reduce-intervertebral-foramina-and-peer-reviewed-fulltext-article-JPR |
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