Operative treatment of lumbar spinal stenosis with interspinous implants: General overview

Abstract

Interspinous process devices are an alternative treatment of symptomatic lumbar spinal stenosis (LSS) to conventional surgery. Are presented various kinds of interspinous devices: X-STOP, IN-SPACE, SUPERION, APERIUS, ceramic spacers. 
Pathophysiology of lumbar spinal stenosis is presented together with biomechanics of interspinous implants which reduce loads on the facet joints, reduce pressure in the posterior annulus, increase foraminal and spinal canal dimensions.
Indications, contraindications and precautions related to interspinous device surgery are presented.
The results of in vitro studies are confirmed in randomized clinical trials. The improvements are statistically and clinically important, compared to those reported for laminectomy.