Introduction: Three neurosurgical centers in Italy are performing lumbar arthrodesis using interspinous/interlaminar fusion with fixed "U" shaped device and bone substitutes and interbody cages. The purpose of this clinical assesment is the evaluation of the capacity of the system to create a fusion.

Methods: The arthrodesis in all cases was performed with interspinous/interlaminar fusion device with bone substitute (Finceramica) and interbody cages either posterior lumbar interbody fusion (PLIF) or transforaminal lumbar interbody fusion (TLIF). The posterior system was born to create vertebral arthrodesis inducing a block of movement in the articular district through the simple and safe positioning of the device between the spinous processes. The device features special perferated tabs that anchor firmly to the spinous process and by which you can enter dedicated rivets fastening the device in place. One hundred and ten cases of patients with lumbar stenosis L1-L5 with or without grade one degenerative spondylolithesis were enrolled from June 2011 to November 2013.

Results: The patients were subject to the following analyzes and questionnaires: the personal data and identification of the clinical picture with group studies; descriptive data of the surgical procedure; VAS pre-operative, post-operative at six, twelve and eighteen months; ODI pre-operative, post-operative, six, twelve and eighteen months. The subjective evaluation of pain by the VAS and ODI questionnaires and radiological arthrodesis obtained determine the reliabilty and effectiveness of the system. The results show at 15 months follow-up good outcome in 94 of the 110 patients improved VAS and ODI scores.

Conclusions: The result show how the system is capable of inducing an arthrodesis caparable to that obtainable with pedicle screws and rods, but with clearly many clinical advantages such as: reduced skin incision, reduced muscle trauma due to minimal invasive procedure, reduced risks of screw placement, and reduced surgical time of at least 45 minutes.

Patient Care: Minimal invasive procedure with shortened operative time, blood loss and trauma to spinal structures.

Learning Objectives: Alternative method to pedicle screw fixation.

References: Kabir SM, Gupta SR, Casey AT. Lumbar interspinous spacers: A systematic review of clinical and biomechanical evidence. Spine 2010;35:E1499-506. Jutte P, Castelein R. Complications of pedicle screws in lumbar and lumbosacral fusions in 105 consecutive primary operations European Spine Journal Volume 11, Number 6, 594-598