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BioMed Research International
Volume 2014, Article ID 975052, 15 pages
http://dx.doi.org/10.1155/2014/975052
Review Article

Controversies about Interspinous Process Devices in the Treatment of Degenerative Lumbar Spine Diseases: Past, Present, and Future

1Department of Neurosurgery, San Giovanni-Addolorata Hospital, Via Amba Aradam 9, 00184 Rome, Italy
2Regional Service of Neurosurgery, “Virgen de la Arrixaca” University Hospital, Avenida Primero Mayo, El Palmar, 30120 Murcia, Spain
3Klinik für Neurochirurgie und Wirbelsäulenchirurgie, Fehrbelliner Straße 38, 16816 Neuruppin, Germany

Received 8 January 2014; Revised 16 February 2014; Accepted 23 February 2014; Published 13 April 2014

Academic Editor: Vijay K. Goel

Copyright © 2014 Roberto Gazzeri et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

A large number of interspinous process devices (IPD) have been recently introduced to the lumbar spine market as an alternative to conventional decompressive surgery in managing symptomatic lumbar spinal pathology, especially in the older population. Despite the fact that they are composed of a wide range of different materials including titanium, polyetheretherketone, and elastomeric compounds, the aim of these devices is to unload spine, restoring foraminal height, and stabilize the spine by distracting the spinous processes. Although the initial reports represented the IPD as a safe, effective, and minimally invasive surgical alternative for relief of neurological symptoms in patients with low back degenerative diseases, recent studies have demonstrated less impressive clinical results and higher rate of failure than initially reported. The purpose of this paper is to provide a comprehensive overview on interspinous implants, their mechanisms of action, safety, cost, and effectiveness in the treatment of lumbar stenosis and degenerative disc diseases.