Background: To investigate dural sac enlargements and spinal alignments in patients who underwent indirect decompression with interspinous spacers.
Methods: The subjects were 20 patients who underwent indirect decompression using an interspinous spacer (X-STOP) without laminectomy. Of these 20 patients, 1 patient underwent implant removal surgery 1 month after X-STOP surgery and two patients dropped out. Ultimately, 17 patients were included in this study. MRI and X-ray images were investigated before surgery, 1 week after surgery, 3 months after surgery, and 2 years after surgery.
Results: On MRI, the mean cross-sectional areas of the dural sac were 52.7 mm before surgery, 73.2 mm 1 week after surgery, 62.4 mm 3 months after surgery, and 58.3 mm 2 years after surgery. There was a significant 37% increase at 1 week postoperatively compared with that before surgery, but there were no significant differences between 3 months postoperatively and 2 years postoperatively. The disc angle in an extension posture was significantly decreased at 1 week after surgery compared with that before surgery, but there were no significant differences between before surgery, 3 months after surgery, and 2 years after surgery.
Conclusions: The interspinous process spacer increased the dural sac area by 37% 1 week after surgery, but the enlargement was not maintained at 3 months or 2 years after surgery. The use of interspinous process spacers produced an enlargement of the dural sac by limiting extension of the stenotic level only. However, its effect diminished 2 years after surgery.
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| http://dx.doi.org/10.1016/j.jos.2019.08.018 | DOI Listing |
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