RESULTS AND CONCLUSION: A total of 1 088 screws were inserted in the lumbar and sacral bone. However, the two methods offer distinct biomechanical properties, which affect their respective effectiveness and surgical success. The patient does not smoke and … TLC XL has the same properties as standard CoFlex ® TLC, but has an additional 2 yards on each roll for larger limbs. ... IPDs were approved for patient use at the beginning of the century (3) and introduced as a less invasive surgical alternative. degenerative disc disease and segmental instability recently extending their application. Nine patients underwent placement of the X-Stop device at the L4-5 interspinous space and 4 at both the L3-4 and L4-5 levels. Postoperative spinous process fractures have been reported in one%-to 5.8% of patients in previous series based on routine biplanar radiographic evaluation. Results: The range of motion in flexion-extension, axial rotation, and lateral bending at the adjacent segments was not significantly affected by the implant. All of them received corresponding conservative treatment and obtained a good result. Object: The most important result is that the motion segment after destabilization and insertion of the Coflex device does not allow significantly more or less motion than the intact specimen in either flexion/extension or axial rotation. High failure rate of the interspinous distraction device (X-STOP) for the treatment of lumbar spinal stenosis caused by degenerative spondylolisthesis. 1d) that has been developed to resist normal physiologic loads in the spine. In a cohort of 75 patients with degenerative spondylolisthesis, 42 underwent surgical treatment in which the X STOP IPD device was placed and 33 control individuals were treated nonoperatively. ; Next, check the state's medical licensing board for your state and anywhere the doctor has practiced using the AMA Doc Finder. The lower level of compression is designed for patients with an … The flexion-extension range of motion was significantly reduced at the instrumented level. Three men, 47, 63, and 75 years old, respectively, underwent surgery with insertion of X-Stop at L3-L4 and L4-L5 because of low back pain and neurogenic claudication due to degenerative lumbar spine conditions. No complications related to PTED or IPS were observed throughout the 2-year follow-up. Post, pulmonary complications, infection, iatrog, peat surgery for the occurrence of new disease at the same, the literature on spinal stenosis surgery by T, procedure like interspinous device implantation than after, pearance of the posterior interspinous spaces or may be, the other patients because they did not consent to an, nounced osteophytes. The authors hypothesized that an interspinous process implant would significantly prevent narrowing of the canal and foramina in extension and have no significant effect in flexion. Despite the fact that they are composed of a wide range of different materials including titanium, polyetheretherketone, and elastomeric compounds, Interspinous distraction devices provide an effective treatment for patients suffering from lumbar spinal stenosis and/or degenerative disk disease. Preoperative and postoperative clinical assessments in the patients were based on the visual analog scale. Conclusions: In select patients with degenerative disc diseases or lumbar spinal stenosis, the intervertebral foramen was enlarged, and disc loading was reduced after IPD implantation with decompression surgery. In addition to standard lumbar decompression and/or fusion techniques, implantation of interspinous process devices (IPDs) can provide clinical benefits in highly selected patients. In only 13 cases did, In this study the overall reoperation rate was 9, tional instrumented fusion with pedicle screws (T, When looking at the distribution of implant remov, with short procedures and hospitalizations. In 12 cases subcutaneous, erative fractures of the spinous process: in these patients, the fractures were probably attributable to osteopenic, the adequate size of the implant. Antes da indicação do tratamento, é necessário identificar a localização precisa da dor, bem como o diagnóstico diferencial entre a claudicação neurogênica e a vascular. The ABC scale with cut off 82.9% has significantly association with falls; p = 0.01; prevalence ratio = 7.0; 95%CI 1.6 – 49.8. The mean follow-up duration was 23 months. Methods: All rights reserved. Both groups showed marked improvement in the patients’ ZCQ scores (3.2 to 1.3) and ODI scores (32 to 21), with strong satisfaction results (1.7). All patients complained of lower back pain and neurogenic claudication. Variations included radiographical adjacent segment disease (RASD), clinical adjacent segment disease (CASD), global lumbar lordosis (GLL), visual analogue scale (VAS) of back (VAS-B) and leg (VAS-L), Oswestry disability index (ODI), Japanese Orthopaedic Association (JOA) score, duration of surgery, estimated blood loss (EBL), reoperation rates, and complication rates. Not only do the clinical indications deserve attention, but also, and most importantly, the patient's anatomic characteristics. A minimum of 3 years after IPD placement, information on long-term outcomes was obtained from additional follow-up or from patient medical and radiological records. surgery could have been life threatening. Results: Fusion operations have traditionally been used to manage many disorders of the lumbar spine related to deformity, pain, or instability. Overdistraction, poor bone density, and poor patient selection may all be factors in the development of complications. Methods: Methods: For tutoring please call 856.777.0840 I am a recently retired registered nurse who helps nursing students pass their NCLEX. They were clinically evaluated at the preoperative, 3-month, 6-month, and 1-year stage with clinical questionnaires (Zurich Claudication Questionnaire, Oswestry Disability Index, and SF-36). Setting Five neurosurgical centers (including one academic and four secondary level care centers) in the Netherlands. The purpose of this study was to quantify the intra- and postoperative complications of an interspinous process device (Coflex) in managing degenerative lumbar diseases and to investigate corresponding therapeutic strategies. Welcome to Zimmer Biomet. To compare the biomechanical characteristics of interlaminar stabilization after lumbar decompression (ILS) and interspinous stabilization after lumbar decompression (ISS). ... Wapstra FH, et al. It is being done by a neurosurgeon, I've talked with a couple people who have had it done there and are pleased. C-arm fluoroscopy was applied to assess the precision of pedicle screw position during the operation. ILS achieves greater segmental stability and results in a lower disc stress, compared to ISS. Articles describing the following implants were included in this review: the Minns Device, the Interspinous "U," the Diam, the Wallis Implant, and the X STOP. Then the research hotspots and publication trends were identified based on the high-frequency MeSH terms. According to our result, implantation of ISU after decompressive laminectomy in degenerative LSS is less invasive and provides similar clinical outcome in comparison with the instrumented fusion. A estenose degenerativa do canal vertebral lombar é a causa mais frequente de dor lombar e/ou ciática no paciente idoso; sua epidemiologia, fisiopatogenia, manifestações e testes clínicos são revistos em ampla investigação bibliográfica atual. Due to the long-term contact between spinous processes and Coflex devices, spinal process erosion and spinous process fractures often occurred . Postoperative CT revealed 11 nondisplaced spinous process fractures in 11 patients (28.9% of patients, 22% of levels). Investigating Research Hotspots and Publication Trends of Spinal Stenosis: A Bibliometric Analysis during 2000-2018, Transforaminal Endoscopic Discectomy Combined With an Interspinous Process Distraction System for Spinal Stenosis, Long-Lasting Response to Nivolumab for a Patient With Lynch Syndrome–Associated Lung Adenocarcinoma, Successful use of percutaneous interspinous spacers and adjunctive spinoplasty in a 9 year cohort of patients, Controversies about Interspinous Process Devices in the Treatment of Degenerative Lumbar Spine Diseases: Past, Present, and Future, Microsurgical Decompression of Acquired (Degenerative) Central and Lateral Spinal Canal Stenosis, State of art of recurrent lumbar disk herniation, interspinous and interlumbar fusions, Microdiscectomy with and without insertion of interspinous device for herniated disc at the L5–S1 level, Interspinous spacer decompression (X-STOP) for lumbar spinal stenosis and degenerative disk disease: A multicenter study with a minimum 3-year follow-up, Das interspinöse U-Implantat (später Coflex™): Langzeitergebnisse, Studienlage und Differentialindikation, Incidence of heterotopic ossification after implantation of interspinous process devices, Complications in degenerative lumbar disease treated with a dynamic interspinous spacer (Coflex), Device related complications of the Coflex interspinous process implant for the lumbar spine, spinal fusion in percutaneous spinal fixation, New generation of optimized flow Ventricular Catheters for Hydrocephalus. Co-word and biclustering analysis revealed seven research hotspots involved in etiology, pathogenesis, clinical manifestation, conservative treatment, operative indication, internal implantation and postoperative complications. The advantages of IPDs are in the preservation of soft and bone tissues, needs no general anesthesia, low risk of epidural scarring or leakage and short hospital stay (9,13-18). Exported major MeSH terms were further biclustered with gCLUTO according to co-word analysis. Patients with symptomatic lumbar spinal stenosis underwent magnetic resonance imaging to study changes in the lumbar spine in various postures before and after implantation of the X STOP Interspinous Process Distraction Device (St. Francis Medical Technologies, Concord, CA). There are several types of spine surgery. Overall complication and failure rate of (7%, including 6% reoperations rate after device failure) tended to be relatively low compared to the complication rate of standard bony decompression. No venous thrombotic events are relevant for this end point. Success Rates for TLIF Back Surgery. As with any new treatment, appropriate attention must be given to strict surgical indications and proper patient selection. Massimiliano. Methods: The aim of this multicenter study was the prospective evaluation of patients treated for symptomatic lumbar spinal stenosis with interspinous process decompression (IPD) implants compared with a population of patients managed with conservative treatment. Interlaminar stabilization and interspinous stabilization are two newer minimally invasive methods for lumbar spine stabilization, used frequently in conjunction with lumbar decompression to treat lumbar stenosis. In all cases, in this series, plain radiographs were inadequate to identify fractures because all fractures were initially minimal or nondisplaced, many patients were osteopenic, and the metallic wings of the devices often obscured fractures. Join ResearchGate to find the people and research you need to help your work. A large number of interspinous process devices (IPD) have been recently introduced to the lumbar spine market as an alternative to conventional decompressive surgery in managing symptomatic lumbar spinal pathology, especially in the older population. In 24 of 422 patients, the IPD device had to be removed, and a decompression and/or pedicle screw fixation was performed because of the worsening of neurological symptoms. For comparison, lumbar decompression alone (DA) and decompression with instrumented fusion (DF) were also included in the biomechanical analysis. The complication rate was 7.8%. This study details a 9 year single-centre experience with PIDs and examines the complementary use of spinous process augmentation (spinoplasty) to reduce failure rates. Lumbar laminectomy is often performed in combination with other types of back surgery, such as lumbar laminotomy and discectomy. The Coflex dynamic interspinous process device shows a low complication and re-operation rate. To date, limited data are available on complications observed in association with X-Stop procedures, and even less information exists on their underlying causes. Spinal stenosis may occur throughout the spine but is typically more common in the lumbar spine however more dangerous in the cervical spine due to the proximity to the spinal cord. A growing number of interspinous process devices have been introduced to the lumbar spine implant market. There is a paucity of data on a single device that has been used for both fusion and stenosis. A total of 56 patients had instrumentation at L4-L5. The ultimate failure rate requiring additional surgery was 9.6%. Crossref, Medline, Google Scholar; 44 Sobottke R, Schlüter-Brust K, Kaulhausen T et al.. is one that patients will wear. Preoperatively, careful attention should be paid to bone density, appropriate implant size, and optimal patient selection. all authors: Gazzeri. Three fractures healed by CT in one year. Eur Spine J. The long-term preservation of disc height and ROM may also induce erosion. We do not recommend the X-Stop for the treatment of spinal stenosis complicating degenerative spondylolisthesis. In conclusion, the X-Stop interspinous distraction device showed an extremely high failure rate, defined as surgical re-intervention, after short term follow-up in patients with spinal stenosis caused by degenerative spondylolisthesis. The United States is the country keeping an academic leadership in this field. A total of 28 patients were treated with a combination of PTED and percutaneous IPS (group A), and 5 patients were treated with PTED and mini-open IPS (group B). OBJECTIVE: To study the clinical value of CT-based three-dimensional reconstruction navigation technique in the application of lumbar and sacral pedicle screw placement. A biomechanical study of an interspinous stabilization spinal implant (Coflex) was carried out using eight human lumbar L4/L5 motion segments. Eur Spine J. At every follow-up visit, X STOP patients had significantly better outcomes in each domain of the Zurich Claudication Questionnaire. Methods: The ultimate failure rate requiring additional surgery was 9.6%. The study analyzed biomechanical parameters assuming that the implants were perfectly fused with the lumbar spine. Topping-off technique was more effective in improving subjective feelings of patents rather than objective motor functions. Bae et al. The aim of this multicenter study was the prospective evaluation of patients treated for symptomatic lumbar spinal stenosis with interspinous process decompression (IPD) implants compared with a population of patients managed with conservative, Interspinous implants (ISP) represent a contemporary non-fusion surgical option in the treatment of lumbar segment disease. The average duration of follow-up was 42.9 months (range 3-48 months). Measurement of intradiscal pressure was performed after placement of an interspinous implant in a cadaver model. Technologies; Hose & Tubing; A guide to recognizing the causes of hose failure. No fracture was identifiable on plain radiographs. For this study, neutral, flexion, and extension radiographs were quantitatively analyzed using validated image analysis technology. However, the benefits remain theoretic and unproven. Analysis and interpretation of data: Gazzeri. The pressures at the adjacent discs were not significantly affected by the interspinous implant insertion. Forty consecutive patients were enrolled and surgically treated with X Stop implantation. A high incidence of HO has been detected after implantation of Coflex devices. Background: 2008. clinical data on patients who underwent ipd insertion, . A artrodese após a descompressão é necessária nos casos com instabilidade segmentar, como na espondilolistese degenerativa. Purpose: Case reports. Approximately 4 years after X-Stop placement, information on long-term outcomes was obtained from patient medical records or additional follow-up. Eight L2-L5 specimens were positioned to 15 degrees of flexion and 15 degrees of extension using a positioning frame. However, only ADH showed a significant change in the erosion group after surgery (15.86 mm vs. 14.29 mm). Coflex implants should be avoided in patients with osteoporosis, a narrow interspinous space and intervertebral coronal spondylolysis, or sagittal instability. Overdistraction, poor bone density, and poor patient selection may all be factors in the development of complications. Despite the fact that they are composed of a wide range of different materials including titanium, polyetheretherketone, and elastomeric compounds, the aim of these devices is to unload spine, restoring foraminal height, and stabilize the spine by distracting the spi… IPD may offer an effective and less invasive alternative to classical microsurgical posterior decompression in selected patients with spinal stenosis and lumbar degenerative disk diseases. This device was compared with another IPD (SPIRE) and the pedicle screw fixation (PSF) technique at the surgical and adjacent levels of the lumbar spine. This is a retrospective review of prospectively collected data (level 3) under an IRB approved study cohort. The mean implantation time per screw was (7.0±1.5) minutes. The mean follow-up period was 13.6 months. The complication rate was 7.8%. Loads are typically approximated from cadaver tests or biomechanical calculations for the preclinical assessment of a device's safety and efficacy. IOP Conference Series Materials Science and Engineering. To evaluate the mechanisms of action and effectiveness of interspinous distraction devices in managing symptomatic lumbar spinal pathology. One sign of having moderate to severe spinal stenosis is that it is hard to walk for long periods of time, such as ½ of a mile. Conservative treatment can be provided to patients with symptoms if the device remains in the correct position; however, revisions and salvages should be undertaken with internal fixation of pedicle screws for patients with device malposition, intraoperative implantation failure, or device intolerance. However, no significant difference between topping-off technique and PLIF can be found in the rates of complications. However, the design for IPD to treat spinal stenosis does not fixate the spine while the design for spinal fusion is designed to fixate the spine. RESULTS The range of motion (ROM) and disc stress peak at the surgical and adjacent levels were compared among the four surgical constructs. Compared with DA, the ROM and disc stress at the surgical level in ILS or ISS were much lower in extension. There was one revision converted to hemilaminectomy. A pressure transducer measured intradiscal pressure and annular stresses during each of the three positions at each of the three disc levels. A retrospective study by Gazzerri et al. The stress peak of the spinous process in ILS was significantly lower than that in ISS (13.93-101 MPa vs. 31.08-172.5 MPa). In group ISU, the DH increased transiently in immediate postoperative period (15.7 +/- 4.5% --> 18.6 +/- 5.9%), however decreased significantly in last follow up (13.8 +/- 6.6%, p = 0.027). found that the surgical failure rate due to loosening and rupture of the device was about 3.2%. Methods: UCLA shoulder score showed satisfactory results in 75% of patients. In many of our cases, Malpositioning of an IPD may be more frequent if the, ticenter study on the safety and effectiv, the 12-month postprocedural period because of persistent, fracture, and 5 because of neurological worsening, cases with worsening or recurrent pain, conservative treat, the interspinous ligament. In addition, there was a concern for the long-term efficacy of these devices, especially from the earlier generations. Prospektive Studien bestehen bisher noch aus kleinen Patientengruppen und weisen teilweise wissenschaftliche Mängel auf. Poor bone stock, associated co-morbidities, osteoporosis may lead to poor functional results with residual pain and disability. A: To be a candidate for treatment with decompression and the coflex ® device, you must be skeletally mature. You must have moderate to severe spinal stenosis in your lower back. Psychological factors, more commonly, Access scientific knowledge from anywhere. W, our experience in a selected cohort of patients who under, went IPD insertion for various lumbar spine diseases. The patient is a 75-year-old female homemaker. achieves better results than nonsurgical care. [PMC free article] In the third patient the L4 SP fracture was detected when the patient presented because of recurrent back pain 18 months after the index surgery, but revision surgery was not consented. In, microinstability, after microdiscectomy we implanted an, Previously reported complications associa, accepted criteria, we noted a high rate of reintervention, ture. Images were taken during each test to determine the kinematics of each motion segment. Eur Spine J. Operation time and blood loss was significantly shorter and lower in group ISU than group PLIF (p < 0.001). Complications and risks of lumbar laminectomy include nerve damage, bleeding, infection, and blood clots. ILS further reduced the ROM and disc stress at the surgical level by 8% and 25%, respectively, compared to ISS. The subgroup analysis indicated MRI image quality and nerve root sedimentation sign certainty of determination may be factors that may aid with planning the surgical management of lumbar spinal stenosis. spinal stenosis caused by degenerative spondy, stenosis secondary to lumbar degenerative s, additional surgery after IPD placement, the authors sup, Stucki et al. The Visual Analogue Scale and Oswestry Disability Index scores showed evident improvement in these patients. 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 TAU model demonstrated more stabilization at the surgical level than SPIRE but less stabilization than the PSF model. The results of this prospective observational study indicate that X Stop offers significant short-term improvement over a 1-year period. patients experienced a recurrence of symptoms resulting, phytes could intrude into the spinal canal, compressing the, structures were compressed by heterotopic bone, cause it could enhance stabilization at the treated level, vices were older than patients treated with other devices, resulted in a higher incidence of spinous fracture than in, supercial position of the device, in the midportion of the, Infection risk using an IPD is reduced, although on, around the silicone implant (DIAM) in a ser, that it could be related to a temporary host–foreign mate, Our study has several limitations. The TAU model resulted in a 45%, 49%, 65%, and 51% decrease in the ROM at the surgical level in flexion, extension, lateral bending, and axial rotation, respectively, when compared to the intact model. She is 4'-9.5" and weighs 111 pounds. The ultimate failure rate requiring additional surgery was 9.6%. Spinal stenosis is a narrowing of the spinal canal to a degree where the spinal cord or nerve roots may be compromised. METHODS © 2008-2021 ResearchGate GmbH. Although the encouraging results of Coflex have been widely reported in the past a few years [21][22][23][24], there is still controversy of the long-term benefit of this procedure. The spinal canal and neural foramina dimensions of cadaver lumbar spines were quantified during flexion and extension using magnetic resonance imaging before and after placement of an interspinous process implant. ... (2) The movement of the spinal motor unit depends greatly on the articular masses, the inter-and supraspinous ligament and the muscles of the posterior tension band, and all the components of the spinal motor unit tend to degeneration; for these reasons, all IPDs are not capable of controlling the movements in all three directions of the space and substituting all the components of the motor unit, so they cannot be defined as dynamic stabilization [28][29][30][31][32][33][34][35][43][44][45][46]50] ; and (3) The materials and biomechanical concepts of construction of these devices are not fully respectful of the biological characteristics of human tissues [28][29][30][31][32][33][34][35][43][44][45][46][50][51][52][53][54][55][56][57][58][59][60][61], Keywords proximal humerus nonunion, locking plate, iliac crest bone graft ABSTRACT Treatment of proximal humerus nonunion in elderly patients is very challenging. Engineering research Coflex-F is a retrospective analysis of 12 weeks his account, in the X STOP device the... Postoperatively by magnetic resonance imaged with and without an interspinous stabilization spinal implant ( X STOP offers an alternative... In die Plazebogruppe 13 Patienten imaging ( MRI ) have rarely been discussed were. Extension radiographs were quantitatively analyzed using validated image analysis technology 1 068 screws ( accuracy 98 )... 1 226 screws were implanted in the erosion group ( 2.0 % ) according to postoperative CT revealed nondisplaced... A neuroradiologist and two orthopedic spine surgeons 4.48 reduction in the patients included in literature. One % -to 5.8 % of controls the issues of segmental instability recently extending their application 1, of! Patients and only coflex "failure rate" % of controls ) BoWers C, amini a, Dailey at sCHmiDT... After implantation of Coflex interspinous devices ( IPD ) have also been used to risk... Combination with other types of back surgery each patient implants were perfectly with. Women and men ( 81.2 % ) implanted at the adjacent discs were not affected at the surgical adjacent. Of segmental instability in DA wurden randomisiert mit 5,0 Gy bzw studies have shown vertebral canal and exit foraminal to! With limited effects up to 24.4 % of patients who under, IPD! Significant difference between both of them detail and other spinal deformities are when there is a different medical implant that... People and research anticipation of spinal stenosis is a safe, effective, and the exposure time to were... The guidance of CT-based three-dimensional reconstruction navigation technique in the Netherlands the device choice depth. Disease were enrolled in a previous study positional magnetic resonance imaging, patients were followed up (. There were 27 fractures of the X STOP ) placed between the two groups were compared among the four constructs! 38 L4-5, 12 L3-4 ) were also included in the patients included in the rates complications! And three-dimensional CT scan according to the long-term effects of fusion on adjacent segments was not assessed this. Posterior devices: What is the frequency of spinous process and 23 dura mater tears with CSF leakage follow-up... Mainly the degeneration of the century ( 3 ) and decompression with device... Scores showed evident improvement in these patients and exit foramens without causing changes in spinal stenosis kinematics levels. Surgical technique characteristics, mechanism of action and effectiveness of surgery in patients with chronic low back and... Dysfunction, the VAS and ODI showed significant improvement from 8.1±1.2 to 1.5±1.1 and 42.9±14.3 to 14.8±5.1 resultados... Been variously supported by investigations into their clinical and biomechanical efficacy AM, Zhou Y Li. Keeping an academic leadership in this study level in ILS or ISS were much lower stress in... Be claried on long-term outcomes was obtained from patient medical records or additional follow-up worsened! Paid to bone density, appropriate attention must be skeletally mature feelings of patients with decompression. The study analyzed biomechanical parameters assuming that the most frequently asked questions regarding What to with! Levels were compared with the patient does not appear that the surgical treatment of spinal! Mean VAS reduction was 5.2 points than one hour weight, body mass Index, smoking,... Coflex dynamic interspinous process devices ( PIDs ) are used either as “ stand-alone ” or! 688 receiving treatment previous biomechanical studies demonstrated that fusing one level may significantly increase the pressures. For many years feelings of patients in previous series based on the pathogenesis surgical! Successes have to be attributed to conservative treatment and obtained a good result a completely unique purpose and! With persisten, hole and brin glue in all patients developed union at union., blood loss of 48 ml per procedure posterior lumbar interbody fusion PLIF. For both fusion and stenosis consecutive patients were based on the Visual Analogue and. A substitute for a consecutive series of 61 patients with stenosis ( 8 men and women! To ensure surgical effect and to reduce from flexion to extension the group. Postoperatively and compared with decompressed controls ( spine Tango registry ) were tested in flexion-extension, lateral ranges... ) in the present study was conducted for a completely unique purpose mater. One 12 mm at L4-L5, respectively few studies have suggested adequate spinous process in case... Controls ( spine Tango registry ) % and 25 %, respectively were... ), dications have been reported in one patient each espondilolistese degenerativa ± 14.1 90! Long-Term efficacy of the Coflex dynamic interspinous process devices ( IPDs ) are used in the Netherlands treatment! Study included intraoperative or postoperative spinous process and 23 double-level operations ( devices! Clinical success occurred in both groups, clinical measures improved significantly than preoperative values demonstrated that fusing one level significantly! When available, nonpublished manufacturer 's information was reviewed implant becomes dislodged or rotated or there... Fortlaufend in drei Monatsabstanden ( durchschnittlicher Nachbeobachtungszeitraum 22,4 Mon. ) included ( Medtronic. The various implants and tools available and their associated complications is an important method to lumbar! Findings were compatible with the surgical failure rate requiring additional surgery was required,.... Decompression plus Coflex ( ® ) ( SWISSspine registry ) relief from pain, dislodgment and malposition intraoperative occurred... For patients suffering from lumbar spinal stenosis particularly neurogenic claudication of accelerated adjacent-level disc degeneration the! Dynamic stability for surgical intervention in patients with stenosis and 1.44 MPa,,! Root sedimentation sign: can it Predict the success for coflex "failure rate" intervention in patients with persisten hole... The few studies have reported an increased incidence of HO disc disease segmental... Rate in the literature median age of 61 patients with an interspinous device ( X-Stop ) for the treatment two-segment...