Two-year results of interspinous spacer (X-Stop) implantation in 175 patients with neurologic intermittent claudication due to lumbar spinal stenosis

Brief Review

이 논문은 요추협착증 때문에 신경이 간헐적으로 파행되어 척추 극돌기간에 X-Stop이라고 하는 고정체를 삽입한 환자들을 2년간 추적조사한 내용 입니다.

X-Stop 삽입술을 시행한 환자 175명을 대상으로 VAS, ODI를 조사한 결과 수술 후 6주, 2년이 지난 시점에서의 평균VAS는 통계적으로 유의하게 감소하였고, 평균ODI는 유의하게 향상되었습니다.

X-Stop삽입술은 심한 협착증이 있을 경우에는 미세 수술적 감압술을 대체할 수는 없지만 몇몇 특정한 협착증 환자에게는 안전하고 효과적이며 덜 침습적인 수술방법이 될 수 있다는 결론 입니다.

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*Title: Two-year results of interspinous spacer (X-Stop) implantation in 175 patients with neurologic intermittent claudication due to lumbar spinal stenosis.

요추 협착증 때문에 신경이 간헐적으로 파행된 175명의 환자에 대해 극돌기간 고정체 삽입술을 시행한 후 2년의 결과

*Authors: Johannes Kuchta, Rolf Sobottke, Peer Eysel, Patrick Simons

*Bibliography: Eur Spine J. 2009 Jun;18(6):823-9.

Background of data

The X-Stop is the most commonly used interspinous distraction device in patients with neurogenic intermittent claudication due to LSS.

Methods

▶Subject: 175 patients an X-Stop implanted in 1 or 2 level (2003~2007)

▶Evaluating method(clinical): VAS (leg pain), ODI (Oswestry disability index)

-follow-up period: up to 4 years

       

Results

▶Mean VAS

61.2% (pre) --> 39.0% (6weeks)--> 39.0% (24 months)

▶Mean ODI

32.6% (pre) --> 22.7% (6weeks)--> 20.3% (24 months)

-8 patients had to be removed and performed microsurgical decompression because of unsatisfactory effect of the X-Stop implanted surgery.

-This study results indicate satisfactory short-term and good long-term effect during a follow-up period of 2 years.

-Functional MRI examinations provide helpful, positional-dependent preoperative information.

Conclusions

-Implantation of the X-Stop device is a minimally invasive, effective and safe procedure.

-The interspinous device does not replace microsurgical decompression in patients with massive stenosis and continuous claudication, but offers a save, effective and less invasive alternative in selected patients with spinal stenosis.

-Functional (upright-) MRI examinations were able to demonstrate the positional-dependent stenosis.