Posterior Dynamic Fixation: Interspinous Devices

GUIDELINES: POSTERIOR DYNAMIC FIXATION: INTERSPINOUS DEVICES

Indications according to the FDA (based on the X-stop Device):

1. Patients 50 or older
2. Neurogenic claudication of lower limbs
3. Proven spinal stenosis
4. Relief of symptoms with spinal flexion
5. Failed conservative therapy of 6 months
6. Can be used at one or two levels

Contraindications:

1. Allergy to Titanium
2. Significant instability of lumbar spine
3. Ankolysed segment at the affected level or levels
4. Acute fracture of spinous process or pars interarticularis
5. Significant scoliosis
6. Neural compression causing bladder or bowel disturbance
7. Severe osteoporosis
8. Systemic or local infection

Indications according to Prof J Senegas ( Based on the Wallis prosthesis )

1. Discectomy leading to substantial loss of disc volume
2. Second discectomy for recurrence of disc herniation
3. Degenerative disc adjacent to fusion
4. Modic 1 lesion causing chronic back pain
5. Discectomy of transitional level with sacralisation of L5

Posted: October 2009