Neurosurg Focus
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The X-Stop interspinous device is designed for the treatment of patients with neurogenic intermittent claudication due to lumbar spinal stenosis. It distracts the posterior elements of adjacent vertebral bodies, unloading the intervertebral disc, limiting spinal extension, and improving central canal and neuroforaminal stenosis. In this paper, the authors reviewed the complications and failure/reoperation rates in a small series of patients and compared their results with other reported complication and failure/reoperation rates. ⋯ Overdistraction, poor bone density, poor patient selection, and preexistent adjacent foraminal stenosis may all be factors in the development of the aforementioned complications. Thus, careful attention should be paid preoperatively to adjacent-level disease, bone density, appropriate implant size, and optimal patient selection.
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The authors report the use and preliminary results of a novel hybrid dynamic stabilization and fusion construct for the surgical treatment of degenerative lumbar spine pathology. ⋯ The DTO system represents a novel hybrid dynamic stabilization and fusion construct. The technique holds promise as an alternative to multilevel lumbar arthrodesis while potentially decreasing the risk of adjacent-segment disease following lumbar arthrodesis. The technology is still in its infancy and therefore follow-up, when available, remains short. The authors report their preliminary experience using a hybrid system in 24 patients, along with short-interval clinical and radiographic follow-up.