Encouraging results for new interspinous system for lumbar spinal stenosis

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Michele Surace, Department of Orthopaedic and Trauma Sciences, Univeritas Studiorum Insubriae, Varese, Italy, and colleagues reported that preliminary results, published in The European Spine Journal, show that the Aperius PercLID spinal system (Medtronic) is associated with a significant decrease of disability parameters.

The system was used in 35 patients (19 males, 17 females; mean age 64 years) undergoing surgery for neurogenic intermittent claudication, secondary to lumbar spinal stenosis, between January 2008 and December 2010, who had failed on conservative therapy. Surace et al wrote: “The purpose of this device is the decompression of neurological structures in the early stages of the disease, providing a good alternative to more invasive decompressive surgery.” According to Surace et al, the advantage of the system is that it is a totally percutaneous system (involving unilateral short skin incision and fast surgical procedure).
 
The Visual Analogue Scale (VAS) was significantly decreased after surgery—prior to surgery, patients presented  with a mean VAS score of 7 but postoperatively, this was reduced to 2 (p<0.001). Surace et al reported: “The Zurich Claudication Questionnaire score was also significantly decreased postoperatively, with an average reduction of 21.89% compared to preoperative values (p<0.001). The Oswestry Disability Index (ODI) score as well showed a significant reduction postoperatively of an average 26.09% (p<0.001) when compared to preoperative values.”

Surace et al wrote, in the discussion section of their paper, that a previous study (by Nardi et al) found that the Aperius PercLID interspinous device reduced VAS scores by 37% for low back pain and pain radiating to the lower limbs. They added: “The present study achieves a far better pain reduction of 72%.” Concluding their study, Surace et al wrote: “Despite the short follow-up [mean follow-up was 18 months], results are promising and the success rate is comparable to decompression laminectomy. Longer follow-up is mandatory to confirm these preliminary data and correctly assess the real efficacy of this device in the management of patients affected by degenerative lumbar stenosis.”

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