Vinas-Rios J M, Arabmotlagh M, Rahim T, Schmidt S, Sellei R M, Rauschmann M
Klinik für Wirbelsäulenorthopädie und rekonstruktive Orthopädie, Sana Klinikum Offenbach, Starkenburgring 66, 63069, Offenbach am Main, Deutschland.
Neurochirurgische Gemeinschaftspraxis Wiesbaden, Wiesbaden, Deutschland.
Orthopade. 2019 Oct;48(10):831-836. doi: 10.1007/s00132-019-03772-z.
In the treatment of lumbar spinal stenosis, interspinous spacers can be used in a tissue and time sparing technique. Relief of low back pain might be achieved by stress reduction of facet joints and limitation of segmental mobility.
Presentation of dynamic stabilization by means of an interspinous spacer with and without decompression and to compare it with the outcome of decompression and fusion.
As part of a PubMed search, randomized controlled trials (RCTs) and non-RCTs from high-quality controlled clinical trials were selected and contrasted with our own experience.
The current literature was evaluated, which assesses interspinous spacers with and without decompression in comparison with the "gold standard", the microsurgical interlaminar decompression.
Published data indicate that the use of interspinous spacers with or without decompression for the treatment of lumbar spinal stenosis is not less effective than stand-alone decompression. The reoperation rate can only be proven for implants without decompression on the basis of Level I studies. However, as a link between decompression alone and fusion, it cannot yet provide a scientifically clear solution.
在腰椎管狭窄症的治疗中,棘突间撑开器可用于一种节省组织和时间的技术。通过减轻小关节应力和限制节段活动度,可能实现下腰痛的缓解。
介绍使用和不使用减压的棘突间撑开器进行动态稳定化,并将其与减压和融合的结果进行比较。
作为PubMed检索的一部分,从高质量对照临床试验中选择随机对照试验(RCT)和非RCT,并与我们自己的经验进行对比。
对当前文献进行了评估,该文献评估了使用和不使用减压的棘突间撑开器,并与“金标准”——显微外科椎板间减压进行了比较。
已发表的数据表明,使用有或无减压的棘突间撑开器治疗腰椎管狭窄症的效果不低于单纯减压。仅根据I级研究,可证实无减压植入物的再手术率。然而,作为单纯减压和融合之间的一种联系,它尚未提供科学上明确的解决方案。