Surgical Role of Interspinous Distraction Devices (Coflex, DIAM) for the Treatment of Neurologic Pain and Intermittent Claudication Due to Lumbar Spinal Stenosis

Abstract

Neurogenic intermittent claudication and degenerative low back pain caused by lumbar spinal stenosis (LSS) often occur after the age of 50 years and represent one of the most common degenerative spinal diseases of the elderly. We reviewed medical records and radiographs for patients with LSS who received an interspinous process device (IPD) between October 2009 and December 2010. The aim of the study was to evaluate surgical outcomes for decompressive surgery involving IPD implantation. We reviewed data for 62 patients who were treated with decompressive surgery and IPD (Coflex or DIAM). Neurogenic signs after surgery are important indicators. The patients were examined the day before, 2 weeks after, and 3 months after surgery. Pain was measured according to a visual analog scale (VAS) and neurologic changes were recorded. Postoperative assessments at 2 weeks and 3 months after surgery included pain and neurologic scores and a patient satisfaction survey. For some groups we observed a significant improvement ( p < 0.05) in back pain according to the VAS. Symptom relief on forward flexion is a key indicator for prognosis. Interspinous implants offer significant, long-lasting symptom control and IPDs are safe and effective devices for LSS.