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Neurosurgical Management of Interspinous Device Complications: A Case Series
BACKGROUND: Best practice guidelines for treating lumbar stenosis include a multidisciplinary approach, ranging from conservative management with physical therapy, medication, and epidural steroid injections to surgical decompression with or without instrumentation. Marketed as an outpatient alterna...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8965756/ https://www.ncbi.nlm.nih.gov/pubmed/35372480 http://dx.doi.org/10.3389/fsurg.2022.841134 |
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author | Florence, T. J. Say, Irene Patel, Kunal S. Unterberger, Ansley Laiwalla, Azim Vivas, Andrew C. Lu, Daniel C. |
author_facet | Florence, T. J. Say, Irene Patel, Kunal S. Unterberger, Ansley Laiwalla, Azim Vivas, Andrew C. Lu, Daniel C. |
author_sort | Florence, T. J. |
collection | PubMed |
description | BACKGROUND: Best practice guidelines for treating lumbar stenosis include a multidisciplinary approach, ranging from conservative management with physical therapy, medication, and epidural steroid injections to surgical decompression with or without instrumentation. Marketed as an outpatient alternative to a traditional lumbar decompression, interspinous process devices (IPDs) have gained popularity as a minimally invasive stabilization procedure. IPDs have been embraced by non-surgical providers, including physiatrists and anesthesia interventional pain specialists. In the interest of patient safety, it is imperative to formally profile its safety and identify its role in the treatment paradigm for lumbar stenosis. CASE DESCRIPTION: We carried out a retrospective review at our institution of neurosurgical consultations for patients with hardware complications following the interspinous device placement procedure. Eight cases within a 3-year period were identified, and patient characteristics and management are illustrated. The series describes the migration of hardware, spinous process fracture, and worsening post-procedural back pain. CONCLUSIONS: IPD placement carries procedural risk and requires a careful pre-operative evaluation of patient imaging and surgical candidacy. We recommend neurosurgical consultation and supervision for higher-risk IPD cases. |
format | Online Article Text |
id | pubmed-8965756 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-89657562022-03-31 Neurosurgical Management of Interspinous Device Complications: A Case Series Florence, T. J. Say, Irene Patel, Kunal S. Unterberger, Ansley Laiwalla, Azim Vivas, Andrew C. Lu, Daniel C. Front Surg Surgery BACKGROUND: Best practice guidelines for treating lumbar stenosis include a multidisciplinary approach, ranging from conservative management with physical therapy, medication, and epidural steroid injections to surgical decompression with or without instrumentation. Marketed as an outpatient alternative to a traditional lumbar decompression, interspinous process devices (IPDs) have gained popularity as a minimally invasive stabilization procedure. IPDs have been embraced by non-surgical providers, including physiatrists and anesthesia interventional pain specialists. In the interest of patient safety, it is imperative to formally profile its safety and identify its role in the treatment paradigm for lumbar stenosis. CASE DESCRIPTION: We carried out a retrospective review at our institution of neurosurgical consultations for patients with hardware complications following the interspinous device placement procedure. Eight cases within a 3-year period were identified, and patient characteristics and management are illustrated. The series describes the migration of hardware, spinous process fracture, and worsening post-procedural back pain. CONCLUSIONS: IPD placement carries procedural risk and requires a careful pre-operative evaluation of patient imaging and surgical candidacy. We recommend neurosurgical consultation and supervision for higher-risk IPD cases. Frontiers Media S.A. 2022-03-16 /pmc/articles/PMC8965756/ /pubmed/35372480 http://dx.doi.org/10.3389/fsurg.2022.841134 Text en Copyright © 2022 Florence, Say, Patel, Unterberger, Laiwalla, Vivas and Lu. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Surgery Florence, T. J. Say, Irene Patel, Kunal S. Unterberger, Ansley Laiwalla, Azim Vivas, Andrew C. Lu, Daniel C. Neurosurgical Management of Interspinous Device Complications: A Case Series |
title | Neurosurgical Management of Interspinous Device Complications: A Case Series |
title_full | Neurosurgical Management of Interspinous Device Complications: A Case Series |
title_fullStr | Neurosurgical Management of Interspinous Device Complications: A Case Series |
title_full_unstemmed | Neurosurgical Management of Interspinous Device Complications: A Case Series |
title_short | Neurosurgical Management of Interspinous Device Complications: A Case Series |
title_sort | neurosurgical management of interspinous device complications: a case series |
topic | Surgery |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8965756/ https://www.ncbi.nlm.nih.gov/pubmed/35372480 http://dx.doi.org/10.3389/fsurg.2022.841134 |
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