Aggarwal Nitish, Chow Robert
Department of Anesthesiology, Yale New Haven Hospital, New Haven, CT, USA.
Anesth Pain Med (Seoul). 2021 Apr;16(2):177-183. doi: 10.17085/apm.20093. Epub 2021 Apr 19.
Lumbar spinal stenosis is a condition of progressive neurogenic claudication that can be managed with lumbar decompression surgery or less invasive interspinous process devices after failed conservative therapy. Popular interspinous process spacers include X-Stop, Vertiflex and Coflex, with X-Stop being taken off market due to its adverse events profile.
A disproportionality analysis was conducted to determine whether a statistically significant signal exists in the three interspinous spacers and the reported adverse events using the Manufacturer and User Facility Device Experience (MAUDE) database maintained by the US Food and Drug Administration.
Statistically significant signals were found with each of the three interspinous spacer devices (Coflex, Vertiflex, and X-Stop) and each of the following adverse events: fracture, migration, and pain/worsening symptoms.
Further studies such as randomized controlled trials are needed to validate the findings.
腰椎管狭窄症是一种进行性神经源性间歇性跛行疾病,在保守治疗失败后可通过腰椎减压手术或侵入性较小的棘突间装置进行治疗。常见的棘突间间隔器包括X-Stop、Vertiflex和Coflex,其中X-Stop因不良事件已退出市场。
使用美国食品药品监督管理局维护的制造商和用户设施设备经验(MAUDE)数据库进行不成比例分析,以确定三种棘突间间隔器与报告的不良事件之间是否存在统计学上的显著信号。
在三种棘突间间隔器(Coflex、Vertiflex和X-Stop)中的每一种以及以下不良事件中的每一种中都发现了统计学上的显著信号:骨折、移位和疼痛/症状加重。
需要进一步的研究,如随机对照试验,来验证这些发现。