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2013년 12월 12일 목요일

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

Brief Review

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, ODI 조사한 결과 수술 6, 2년이 지난 시점에서의 평균VAS 통계적으로 유의하게 감소하였고, 평균ODI 유의하게 향상되었습니다.

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

Surgical technique등의 상세한 내용은 아래의 Bibliography 링크된 저널 홈페이지에서 확인하세요!



*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 2년의 결과

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




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.