| Early Experience with Interspinous U in the Management of the Degenerative Lumbar Disease |
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Hyo-Joo Lim, M.D., Sung-Woo Roh, M.D., Sang-Ryong Jeon, M.D. and Seung-Chul Rhim, M.D. |
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Department of Neurosurgery, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea |
| 퇴행성 요추부 질환의 치료에서의 극돌기간 U기구를 사용한 초기 경험 |
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임효주, 노성우, 전상룡, 임승철 |
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울산대학교 의과대학 신경외과학교실 |
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| Abstract |
Objective
An interspinous implant has been developed to treat lumbar neurogenic claudication secondary to spinal stenosis that places the stenotic segment in slight flexion and prevents extension. The authors report their early experience with the semi-rigid stabilization using interspinous U device for treating the degenerative lumbar disease.
Methods
Between June and December 2003, 20 consecutive patients(11 men and 9 women patients; average age 58.8 years, range 39節76 years) underwent spinal operation using interspinous U device. The authors retrospectively analyzed clinical data including radiologic finding and clinical outcome.
Results
Preoperative diagnosis was 17 degenerative stenosis(3 combined with herniated disc, 2 mild spondylolisthesis), 1 recurrent disc herniation, 1 disc herniation, and 1 postoperative instability. Preoperative symptom was 9 lower leg pain, 5 lower back pain, and 6 both. The level of U insertion was L4-5 in 15 patients, L5-S1 in 4 patients, and L3-4 in 1 patient. Visual analogue scale reduced preoperative mean 7.9 to postoperative 2.6. Clinical outcome by Macnab classification was excellent recovery in 6 patients, good in 10 patients, fair recovery in 4 patients. There were 4 dislodgement of the device and 2 second operations related to side effect of distraction property of U device. Mean follow-up period was 5.9 months(range: 3節9months).
Conclusion
In this preliminary result of semi-rigid fixation using interspinous U device for the management of the lumbar degenerative disease and mild degree instability, we had 80% of success rate, 20% of dislodgement of the device, and 10% of revision surgery. But further studies are needed to assess the change of spinal dynamics and the degenerative consequence in the instrumented level and adjacent level.
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| Keywords:
Interspinous device, Degenerative lumbar disease |
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