Measuring Disc Height Increase After Interspinous Fixation Device In Patients Treated By Pain Management Physicians

Authors: Faris Abusharif MD, Micheal Danko MD, Gladstone McDowell MD, Fabio Pencle MBBS, Jason A. Seale MBBS, Kingsley R. Chin MD

Introduction:

Faris Abusharif MD

As we age the reabsorptive capacity of lumbar vertebral discs decrease. Degenerative Disc Disease is the leading cause of lower back pain in an aging population. The advances in technology and treatment options allow for improvements in patient outcomes. This study explores the use of an interspinous interlaminar fixation device to increase disc height on patients with severe disc collapse.

Methods:

A prospective, multicenter study. Study period December 2019 to December 2020 and patients followed up to July 2021.

Inclusion criteria: Patients with over 50% disc height collapse.

Exclusion criteria: Patients with previous spinal fusion at the affected level, BMI >42, malignancy, acute fracture, or trauma. The use of an intraoperative manual distraction measuring device to determine height changes.

Software: Radiant DICOM Viewer tools used to measure disc height on AP x-rays

Results:

  • Average disc height increase by 20-50% (% varied based on the size of implant used)

  • No spinous process fractures.

  • No complication

  • No device failure

  • No revisions

  • Implant range 12-16 mm

  • Average blood loss less than 25 cc

  • 100% of patients had improvement in VAS and Oswestry.

Conclusion:

This study confirmed that the interspinous device is able to distract and maintain distraction over time. 

Limitation: The increase in disc height may not be as significant for patients with less severe disc degeneration. For these patients, the need for an increase in disc height may not be necessary.

References:

  1. Zhou D, Nong LM, DU R, Gao GM, Jiang YQ, Xu NW. Effects of interspinous spacers on lumbar degenerative disease. Exp Ther Med. 2013;5(3):952-956. doi:10.3892/etm.2013.894

  2. Fabrizi AP, Maina R, Schiabello L. Interspinous spacers in the treatment of degenerative lumbar spinal disease: our experience with DIAM and Aperius devices. Eur Spine J. 2011 May;20 Suppl 1(Suppl 1):S20-6. doi: 10.1007/s00586-011-1753-2. Epub 2011 Mar 16. PMID: 21409561; PMCID: PMC3087040.

  3. Chin KR, Pencle FJR, Benny A, Seale JA. Greater than 5-year follow-up of outpatient L4-L5 lumbar interspinous fixation for degenerative spinal stenosis using the INSPAN device. J Spine Surg. 2020 Sep;6(3):549-554. doi: 10.21037/jss-20-547. PMID: 33102891; PMCID: PMC7548832.

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