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Interspinous Spacing Devices
Lubdha M. Shah, MD; Jeffrey S. Ross, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Pathology

        • Clinical Issues

          TERMINOLOGY

          • Synonyms

            • Interspinous posterior decompression (IPD), interspinous distraction device (IDD), interspinous spacer device (ISD), interspinous implant
          • Definitions

            • Interspinous implant places stenotic segment in slight flexion while preventing extension
              • Dynamic stabilization alters movement and load transmission of spinal motion segment without fusion of segment

          IMAGING

          • General Features

            • Radiographic Findings

              • CT Findings

                • MR Findings

                  • Imaging Recommendations

                    DIFFERENTIAL DIAGNOSIS

                      PATHOLOGY

                      • General Features

                        • Staging, Grading, & Classification

                          CLINICAL ISSUES

                          • Presentation

                            • Natural History & Prognosis

                              • Treatment

                                DIAGNOSTIC CHECKLIST

                                • Image Interpretation Pearls

                                  • Reporting Tips

                                    Selected References

                                    1. Wu AM et al: Interspinous spacer versus traditional decompressive surgery for lumbar spinal stenosis: a systematic review and meta-analysis. PLoS One. 9(5):e97142, 2014
                                    2. Lo TP Jr et al: Interlaminar spacer: a review of its mechanism, application, and efficacy. World Neurosurg. 74(6):617-26, 2010
                                    3. Nardi P et al: Aperius PercLID stand alone interspinous system for the treatment of degenerative lumbar stenosis: experience on 152 cases. J Spinal Disord Tech. 23(3):203-7, 2010
                                    4. Barbagallo GM et al: Analysis of complications in patients treated with the X-Stop Interspinous Process Decompression System: proposal for a novel anatomic scoring system for patient selection and review of the literature. Neurosurgery. 65(1):111-19; discussion 119-20, 2009
                                    5. Cabraja M et al: The short- and mid-term effect of dynamic interspinous distraction in the treatment of recurrent lumbar facet joint pain. Eur Spine J. 18(11):1686-94, 2009
                                    6. Chung KJ et al: Stress fracture of bilateral posterior facet after insertion of interspinous implant. Spine (Phila Pa 1976). 34(10):E380-3, 2009
                                    7. Sobottke R et al: Interspinous implants (X Stop, Wallis, Diam) for the treatment of LSS: is there a correlation between radiological parameters and clinical outcome? Eur Spine J. 18(10):1494-503, 2009
                                    8. Sénégas J et al: Clinical evaluation of a lumbar interspinous dynamic stabilization device (the Wallis system) with a 13-year mean follow-up. Neurosurg Rev. 32(3):335-41; discussion 341-2, 2009
                                    9. Brussee P et al: Self-rated evaluation of outcome of the implantation of interspinous process distraction (X-Stop) for neurogenic claudication. Eur Spine J. 17(2):200-3, 2008
                                    10. Verhoof OJ et al: High failure rate of the interspinous distraction device (X-Stop) for the treatment of lumbar spinal stenosis caused by degenerative spondylolisthesis. Eur Spine J. 17(2):188-92, 2008
                                    11. Anderson PA et al: Treatment of neurogenic claudication by interspinous decompression: application of the X STOP device in patients with lumbar degenerative spondylolisthesis. J Neurosurg Spine. 4(6):463-71, 2006
                                    12. Christie SD et al: Dynamic interspinous process technology. Spine (Phila Pa 1976). 30(16 Suppl):S73-8, 2005
                                    13. Richards JC et al: The treatment mechanism of an interspinous process implant for lumbar neurogenic intermittent claudication. Spine (Phila Pa 1976). 30(7):744-9, 2005
                                    14. Wiseman CM et al: The effect of an interspinous process implant on facet loading during extension. Spine (Phila Pa 1976). 30(8):903-7, 2005
                                    15. Zucherman JF et al: A multicenter, prospective, randomized trial evaluating the X STOP interspinous process decompression system for the treatment of neurogenic intermittent claudication: two-year follow-up results. Spine (Phila Pa 1976). 30(12):1351-8, 2005
                                    16. Lindsey DP et al: The effects of an interspinous implant on the kinematics of the instrumented and adjacent levels in the lumbar spine. Spine (Phila Pa 1976). 28(19):2192-7, 2003
                                    17. Swanson KE et al: The effects of an interspinous implant on intervertebral disc pressures. Spine (Phila Pa 1976). 28(1):26-32, 2003
                                    18. Arbit E et al: Lumbar stenosis: a clinical review. Clin Orthop Relat Res. (384):137-43, 2001
                                    19. Inufusa A et al: Anatomic changes of the spinal canal and intervertebral foramen associated with flexion-extension movement. Spine (Phila Pa 1976). 21(21):2412-20, 1996
                                    20. Takahashi K et al: Changes in epidural pressure during walking in patients with lumbar spinal stenosis. Spine (Phila Pa 1976). 20(24):2746-9, 1995
                                    Related Anatomy
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                                    Related Differential Diagnoses
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                                    References
                                    Tables

                                    Tables

                                    KEY FACTS

                                    • Terminology

                                      • Imaging

                                        • Pathology

                                          • Clinical Issues

                                            TERMINOLOGY

                                            • Synonyms

                                              • Interspinous posterior decompression (IPD), interspinous distraction device (IDD), interspinous spacer device (ISD), interspinous implant
                                            • Definitions

                                              • Interspinous implant places stenotic segment in slight flexion while preventing extension
                                                • Dynamic stabilization alters movement and load transmission of spinal motion segment without fusion of segment

                                            IMAGING

                                            • General Features

                                              • Radiographic Findings

                                                • CT Findings

                                                  • MR Findings

                                                    • Imaging Recommendations

                                                      DIFFERENTIAL DIAGNOSIS

                                                        PATHOLOGY

                                                        • General Features

                                                          • Staging, Grading, & Classification

                                                            CLINICAL ISSUES

                                                            • Presentation

                                                              • Natural History & Prognosis

                                                                • Treatment

                                                                  DIAGNOSTIC CHECKLIST

                                                                  • Image Interpretation Pearls

                                                                    • Reporting Tips

                                                                      Selected References

                                                                      1. Wu AM et al: Interspinous spacer versus traditional decompressive surgery for lumbar spinal stenosis: a systematic review and meta-analysis. PLoS One. 9(5):e97142, 2014
                                                                      2. Lo TP Jr et al: Interlaminar spacer: a review of its mechanism, application, and efficacy. World Neurosurg. 74(6):617-26, 2010
                                                                      3. Nardi P et al: Aperius PercLID stand alone interspinous system for the treatment of degenerative lumbar stenosis: experience on 152 cases. J Spinal Disord Tech. 23(3):203-7, 2010
                                                                      4. Barbagallo GM et al: Analysis of complications in patients treated with the X-Stop Interspinous Process Decompression System: proposal for a novel anatomic scoring system for patient selection and review of the literature. Neurosurgery. 65(1):111-19; discussion 119-20, 2009
                                                                      5. Cabraja M et al: The short- and mid-term effect of dynamic interspinous distraction in the treatment of recurrent lumbar facet joint pain. Eur Spine J. 18(11):1686-94, 2009
                                                                      6. Chung KJ et al: Stress fracture of bilateral posterior facet after insertion of interspinous implant. Spine (Phila Pa 1976). 34(10):E380-3, 2009
                                                                      7. Sobottke R et al: Interspinous implants (X Stop, Wallis, Diam) for the treatment of LSS: is there a correlation between radiological parameters and clinical outcome? Eur Spine J. 18(10):1494-503, 2009
                                                                      8. Sénégas J et al: Clinical evaluation of a lumbar interspinous dynamic stabilization device (the Wallis system) with a 13-year mean follow-up. Neurosurg Rev. 32(3):335-41; discussion 341-2, 2009
                                                                      9. Brussee P et al: Self-rated evaluation of outcome of the implantation of interspinous process distraction (X-Stop) for neurogenic claudication. Eur Spine J. 17(2):200-3, 2008
                                                                      10. Verhoof OJ et al: High failure rate of the interspinous distraction device (X-Stop) for the treatment of lumbar spinal stenosis caused by degenerative spondylolisthesis. Eur Spine J. 17(2):188-92, 2008
                                                                      11. Anderson PA et al: Treatment of neurogenic claudication by interspinous decompression: application of the X STOP device in patients with lumbar degenerative spondylolisthesis. J Neurosurg Spine. 4(6):463-71, 2006
                                                                      12. Christie SD et al: Dynamic interspinous process technology. Spine (Phila Pa 1976). 30(16 Suppl):S73-8, 2005
                                                                      13. Richards JC et al: The treatment mechanism of an interspinous process implant for lumbar neurogenic intermittent claudication. Spine (Phila Pa 1976). 30(7):744-9, 2005
                                                                      14. Wiseman CM et al: The effect of an interspinous process implant on facet loading during extension. Spine (Phila Pa 1976). 30(8):903-7, 2005
                                                                      15. Zucherman JF et al: A multicenter, prospective, randomized trial evaluating the X STOP interspinous process decompression system for the treatment of neurogenic intermittent claudication: two-year follow-up results. Spine (Phila Pa 1976). 30(12):1351-8, 2005
                                                                      16. Lindsey DP et al: The effects of an interspinous implant on the kinematics of the instrumented and adjacent levels in the lumbar spine. Spine (Phila Pa 1976). 28(19):2192-7, 2003
                                                                      17. Swanson KE et al: The effects of an interspinous implant on intervertebral disc pressures. Spine (Phila Pa 1976). 28(1):26-32, 2003
                                                                      18. Arbit E et al: Lumbar stenosis: a clinical review. Clin Orthop Relat Res. (384):137-43, 2001
                                                                      19. Inufusa A et al: Anatomic changes of the spinal canal and intervertebral foramen associated with flexion-extension movement. Spine (Phila Pa 1976). 21(21):2412-20, 1996
                                                                      20. Takahashi K et al: Changes in epidural pressure during walking in patients with lumbar spinal stenosis. Spine (Phila Pa 1976). 20(24):2746-9, 1995