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Title of Journal: Eur Spine J

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Abbravation: European Spine Journal

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Springer-Verlag

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10.1016/0005-2728(75)90030-4

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1432-0932

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Effect of a novel interspinous implant on lumbar s

Authors: Robert Gunzburg Marek Szpalski Stuart A Callary Christopher J Colloca Victor Kosmopoulos Deed Harrison Robert J Moore
Publish Date: 2009/02/07
Volume: 18, Issue: 5, Pages: 696-703
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Abstract

Interspinous devices have been introduced to provide a minimally invasive surgical alternative for patients with lumbar spinal stenosis or foraminal stenosis Little is known however of the effect of interspinous devices on intersegmental range of motion ROM The aim of this in vivo study was to investigate the effect of a novel minimally invasive interspinous implant InSwing® on sagittal plane ROM of the lumbar spine using an ovine model Ten adolescent Merino lambs underwent a destabilization procedure at the L1–L2 level simulating a stenotic degenerative spondylolisthesis as described in our earlier work Spine 15571–576 1990 All animals were placed in a sidelying posture and lateral radiographs were taken in full flexion and extension of the trunk in a standardized manner Radiographs were repeated following the insertion of an 8mm InSwing® interspinous device at L1–L2 and again with the implant secured by means of a tension band tightened to 1 N/m around the L1 and L2 spinous processes ROM was assessed in each of the three conditions and compared using Cobb’s method A paired ttest compared ROM for each of the experimental conditions P  005 After instrumentation with the InSwing® interspinous implant the mean total sagittal ROM from full extension to full flexion was reduced by 16 from 63° to 53 ± 27° The addition of the tension band resulted in a 43 reduction in total sagittal ROM to 36 ± 19° which approached significance When looking at flexion only the addition of the interspinous implant without the tension band did not significantly reduce lumbar flexion however a statistically significant 15 reduction in lumbar flexion was observed with the addition of the tension band P = 001 To our knowledge this is the first in vivo study radiographically showing the advantage of using an interspinous device to stabilize the spine in flexion These results are important findings particularly for patients with clinical symptoms related to instable degenerative spondylolisthesis

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