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Spine

LUMBAR INTERSPINOUS SPACERS: A REVIEW OF CURRENT EVIDENCE

Britspine, British Scoliosis Society (BSS), Society for Back Pain Research (SBPR), British Association of Spine Surgeons (BASS)



Abstract

To evaluate the current biomechanical and clinical evidence available on the use and effectiveness of lumbar interspinous devices

Literature review

A PubMed search was done using the following key words: interspinous implants, interspinous devices, interspinous spacers, dynamic stabilization, X-stop, Coflex, Wallis, DIAM. The abstracts of all the articles were reviewed. Further critical analysis was done of the relevant articles. Special emphasis was given to those articles pertaining to biomechanical and clinical results.

A total of 50 articles were found, 18 of them also related to the effect of spacers on the biomechanics of the spine. 25 articles were on the X-stop device. However, level I evidence is lacking. Only two prospective randomized controlled trials have been done and these were on the X-Stop device.

Analysis of current evidence suggests a potential beneficial effect of lumbar interspinous spacers in select group of patients. However, further level I evidence is required to justify their widespread use for all the proposed indications. The results of the ongoing trials are keenly awaited.