Spacer insertion has a potential role as a less costly alternative to conventional operative procedures when conservative treatments have failed or in situations in which patients are unwilling to consider more invasive surgery. According to the analysis by ECRI - an independent nonprofit health services research agency - only one randomized controlled trial of the procedure has been reported. A total of 191 patients at nine centers were randomly assigned to undergo either the spacer procedure or to be treated nonoperatively. Results from this study suggest that for some patients, the spacer procedure reduces pain, improves function for up to two years, and reduces the need for laminectomy - surgery to remove a portion of a disc.
However, this two-year study does not compare the new procedure to other surgical decompressive procedures or treatments for spinal stenosis and does not provide long enough follow-up to determine how long the spacer will last.
To perform the procedure, a spine surgeon makes a one- to two-inch incision over the spine and inserts a small titanium spacer between the spinous processes of two adjacent vertebrae and screws the spacer into place. The spacer is intended to keep the spine from bending too far backward, thus preventing the nerve pinching that causes pain. Since local anesthesia and intravenous sedation are used for the procedure, it can be done on an outpatient basis or with a 24-hour hospital stay.
Patients who undergo interspinous process decompression do not need to undergo more invasive forms of spinal surgery, said Paul Anderson, M.D., an associate professor of orthopedic surgery and rehabilitation at the University of Wisconsin-Madison School of Medicine and Public Health.
MEDICA.de; Source: Health Behavior News Service