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Interspinous Process Spacers

Dr. Kim is Assistant Clinical Professor, Department of Orthopaedic Surgery, New England Baptist Hospital, Boston, MA. Dr. Albert is Professor, Department of Orthopaedic Surgery, Thomas Jefferson University, Philadelphia, PA.

Neither Dr. Kim nor the department with which he is affiliated has received anything of value from or owns stock in a commercial company or institution related directly or indirectly to the subject of this article. Dr. Albert or the department with which he is affiliated has received royalties from DePuy Spine and serves as a consultant to or is an employee of DePuy Spine.

Reprint requests: Dr. Kim, Department of Orthopaedic Surgery, New England Baptist Hospital, 125 Parker Hill Avenue, Boston, MA 02120.

The patient with neurogenic claudication resulting from lumbar spinal stenosis who fails to experience satisfactory relief from nonsurgical measures has limited treatment options. Lumbar epidural steroid injections and surgical laminectomy are generally accepted alternatives for the patient with moderate to severe symptoms. Interspinous process spacers, a relatively new class of technology, are proposed for use in the patient who prefers less invasive surgery or in whom medical comorbidities preclude a major surgical procedure. Early data from biomechanical and clinical studies support the short-term efficacy of interspinous process spacers in treating claudication related to spinal stenosis. Sufficient medium- and long-term data are lacking, however, particularly with respect to durability of symptomatic relief and the risk of device migration or dislocation. Although interspinous process spacers are a promising new technology, the results of longer-term clinical follow-up studies are needed to more clearly define their role in the management of lumbar spinal stenosis.