STUDY DESIGN Facet loading parameters of lumbar cadaver spines were measured during extension before and after placement of an interspinous process implant. OBJECTIVE The study was undertaken to quantify the influence of an interspinous implant on facet loading at the implanted and adjacent levels during extension. SUMMARY OF BACKGROUND DATA Facet loading is increased during extension and d...

STUDY DESIGN Systematic review using a modified network analysis. OBJECTIVES To compare the effectiveness and morbidity of interspinous-device placement versus surgical decompression for the treatment of lumbar spinal stenosis. SUMMARY Traditionally, the most effective treatment for degenerative lumbar spinal stenosis is through surgical decompression. Recently, interspinous devices have be...

A technique of combined expanding laminoplasty using longitudinal interspinous iliac bone graft with posterior lateral mass plate is described for the treatment of cervical canal stenosis associated with spinal instability. A 52-year-old male and a 76-year-old female presented with cervical myelopathy. Imaging studies demonstrated spondylotic cervical canal stenosis associated with spinal insta...

BACKGROUND Lumbar spondylolisthesis (LS) and lumbar instability (LI) are common disorders in patients with low back or lumbar radicular pain. However, few physical examination tests for LS and LI have been reported. In the study described herein, new physical examination tests for LS and LI were devised and evaluated for their validity. The test for LS was designated "low midline sill sign", an...

BACKGROUND Decompressive laminotomy is the standard surgical procedure in the treatment of patients with canal stenosis related intermittent neurogenic claudication. New techniques, such as interspinous process implants, claim a shorter hospital stay, less post-operative pain and equal long-term functional outcome. A comparative (cost-) effectiveness study has not been performed yet. This proto...

STUDY DESIGN Systematic review. OBJECTIVE To evaluate the current biomechanical and clinical evidence available on the use and effectiveness of lumbar interspinous devices and to recommend indications for their use. SUMMARY OF BACKGROUND DATA Lumbar interspinous spacers (ISPs) have recently become popular as an alternative treatment for lumbar degenerative disease. Several spacers are curre...

Lumbar spinal stenosis is a common cause of lowback pain and neurogenic claudication in the adult population. Moreover, degenerative spondylolisthesis ac c ounts for a substantial proportion of lumbar spinal stenosis in this age group. Spinal fusion has become the established operative treatment for unstable degenerative spondylolisthesis.2 However, there are several disadvantages and issues re...

BACKGROUND AND PURPOSE Interspinous spacers are implanted to treat symptomatic lumbar stenosis. Posterior vertebral element fractures can occur during or after interspinous spacer implants, especially in patients with osteopenia. The purpose of our study was to assess the biomechanical rationale, safety, feasibility, and effectiveness of posterior vertebral arch cement augmentation (spinoplasty...

[Purpose] The intra- and inter-examiner reliabilities of lumbar interspinous process distances measured by ultrasound imaging were examined. [Subjects and Methods] The subjects were 10 males who had no history of orthopedic diseases or dysfunctions. Ten lumbar interspinous images from 360 images captured from 10 subjects were selected. The 10 images were measured by nine examiners. The lumbar i...