Introduction: Interspinous process distraction devices have been used in patients with lumbar stenosis and neurogenic claudication with limited success. The sp-fix (Globus Medical Inc., Audubon, PA) is a device that combines distraction with a fusion scaffold. This alteration may ameliorate the weaknesses of the early device due to added biomechanical stability.
Methods: We report a retrospective case series of 102 consecutive patients who underwent surgery for placement of the SP-Fix device for degenerative lumbar stenosis with neurogenic claudication (with and without scoliosis and/or spondylolisthesis) and analyze our institution’s experience in patient-reported symptomatology (using the Oswestry Disability Index [ODI]), complication rate, and reoperation rate in this population.
Results: Of the 102 patients, 44% had spondylolisthesis, 5% had scoliosis, 5% had both scoliosis and spondylolisthesis, and 46% had spinal stenosis without deformity. 8.8% of patients required reoperation (5 for spinous process fracture, 2 for infection, and 2 for failure of symptomatic improvement). Forty-eight patients completed preoperative and postoperative ODI surveys at the 3-month followup, with a mean improvement of 34%. On 91 patients in which data was available, 82% self-reported improvement in leg pain
Conclusions: The case series suggests that patient who undergo placement of the sp-fix experience short-term symptom improvement and lower rates of reoperation than prior generation spinous process distraction devices. Long-term follow up is required to validate the use of this device as an alternative to traditional lumbar laminectomy with or without fusion as a treatment for lumbar spinal stenosis with neurogenic claudication
Patient Care: SP-fix provides a novel, less invasive alternative for the treatment of lumbar spinal stenosis and neurogenic claudication
Learning Objectives: By conclusion of this session, participants should 1) gain better insight into use of interspinous fixation devices 2) understand the indications for sp-fix placement 3) discuss the benefits and drawbacks of sp-fix placement when compared to traditional approaches.
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