Chinese Journal of Tissue Engineering Research ›› 2018, Vol. 22 ›› Issue (31): 5041-5047.doi: 10.3969/j.issn.2095-4344.0568

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Characteristics and clinical applicability of lumbar interspinous spacer

Wang Bao-dong, Lu Jun-feng, Cao Yang   

  1. First Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang Province, China
  • Online:2018-11-08 Published:2018-11-08
  • Contact: Cao Yang, MD, Chief physician, First Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang Province, China
  • About author:Wang Bao-dong, Master candidate, First Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang Province, China
  • Supported by:

    a grant from the Harbin Science and Technology Bureau, No. 2013AA3BS016

Abstract:

BACKGROUND: Lumbar degenerative disease is a common disease in orthopedics. The treatment methods include conservative treatment, interbody fusion and interbody non-fusion, and the classical surgical treatment is posterior lumbar interbody fusion. Non-fusion technology has become more and more widely used, especially the interspinous spacer. Compared with the traditional fusion technology, it has unique biomechanical advantages and ideal clinical efficacy, but the potential problems and deficiencies are gradually emerging.

OBJECTIVE: To review the biomechanical characteristics and disadvantages of interspinous spacer, the value and controversy of clinical applicability, the reasons for the limitation of clinical applicability and the improvement in biomechanics, so as to provide a reference for clinical practice.
METHODS: The first author retrieved CNKI, WanFang, PubMed and SpringerLink databases with the keywords of “lumbar spine, interspinous spacer, interspinous devices, biomechanics, clinical therapeutic effect, cost-effectiveness, complications of interspinous spacer, indication and contraindication of interspinous spacer, spinous process morphology, new interspinous spacer” in English and Chinese, respectively. Relevant studies published between 2003 and 2018 were included and the repeated studies were excluded. Finally, 42 studies were enrolled, with 38 English studies and 4 Chinese studies through reading abstracts.
RESULTS AND CONCLUSION: (1) The interspinous spacer holds special biomechanical characteristics and certain shortcomings in structure. (2) All kinds of interspinous spacers obtain good clinical effects in short- and medium-time follow-up. However, there are some disadvantages, such as high rate of recurrence and reversion, inaccurate clinical efficacy, low cost-effectiveness, and frequent complications. (3) The inaccurate surgical indications and contraindications, unstandardized operation and the specificity in the anatomic morphology of spinous process are the main reasons for the limitation of clinical applicability. (4) The research and development of new device provide an improved concept and direction for biomechanical study. 

中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱骨折;内固定;数字化骨科;组织工程

Key words: Lumbar Vertebrae, Biomechanics, Internal Fixators, Tissue Engineering

CLC Number: