A new ceramic interspinous process spacer for lumbar spinal canal stenosis. 2008

Shunsuke Yano, and Kazutoshi Hida, and Toshitaka Seki, and Takeshi Aoyama, and Minoru Akino, and Yoshinobu Iwasaki
Department of Neurosurgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan. syano@med.hokudai.ac.jp

OBJECTIVE Because surgery in elderly patients should be minimally invasive, interspinous process distraction has been widely used in this group to treat lumbar canal stenosis. We developed a new interspinous process distraction spacer composed of hydroxyapatite ceramic. In this work, we demonstrate the usefulness of this novel device. METHODS Since 2003, we operated on 19 elderly patients with lumbar canal stenosis, including 14 men and five women. Their mean age was 70.1 years. We compared the intervertebral angle, posterior disc height, and interspinous process distance on midsagittal magnetic resonance images obtained before and after the surgery. We also assessed clinical outcomes by using the Visual Analog Scale and the Zurich Claudication Questionnaire. RESULTS The average operation time per level was 44.7 minutes. Postoperatively, there were significant changes in the angle (from 12.5 to 8.6 degrees, P < 0.0001), the posterior disc height (from 10.6 to 13.1 mm, P < 0.0001), and the interspinous process distance (from 9.7 to 14.1 mm, P < 0.0001). The clinical outcomes, which we assessed by using the Visual Analog Scale and the Zurich Claudication Questionnaire, were considered satisfactory. (Visual Analog Scale, from 6.88 to 3.00; Zurich Claudication Questionnaire, symptom severity domain from 2.94 to 1.92, physical function from 2.51 to 1.73.) CONCLUSIONS Our ceramic spacer is useful in the treatment of elderly patients with lumbar canal stenosis. Treatment comprises an easy surgical procedure and produces no metal artifact on radiological evaluations, such as magnetic resonance imaging and computed tomographic scans.

UI MeSH Term Description Entries
D007403 Intervertebral Disc Any of the 23 plates of fibrocartilage found between the bodies of adjacent VERTEBRAE. Disk, Intervertebral,Intervertebral Disk,Disc, Intervertebral,Discs, Intervertebral,Disks, Intervertebral,Intervertebral Discs,Intervertebral Disks
D007595 Joint Prosthesis Prostheses used to partially or totally replace a human or animal joint. (from UMDNS, 1999) Joint Prostheses,Prostheses, Joint,Prosthesis, Joint
D008159 Lumbar Vertebrae VERTEBRAE in the region of the lower BACK below the THORACIC VERTEBRAE and above the SACRAL VERTEBRAE. Vertebrae, Lumbar
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D011859 Radiography Examination of any part of the body for diagnostic purposes by means of X-RAYS or GAMMA RAYS, recording the image on a sensitized surface (such as photographic film). Radiology, Diagnostic X-Ray,Roentgenography,X-Ray, Diagnostic,Diagnostic X-Ray,Diagnostic X-Ray Radiology,X-Ray Radiology, Diagnostic,Diagnostic X Ray,Diagnostic X Ray Radiology,Diagnostic X-Rays,Radiology, Diagnostic X Ray,X Ray Radiology, Diagnostic,X Ray, Diagnostic,X-Rays, Diagnostic
D002516 Ceramics Products made by baking or firing nonmetallic minerals (clay and similar materials). In making dental restorations or parts of restorations the material is fused porcelain. (From McGraw-Hill Dictionary of Scientific and Technical Terms, 4th ed & Boucher's Clinical Dental Terminology, 4th ed) Ceramic
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly

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