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Minimally Invasive Surgery
Volume 2012, Article ID 538697, 5 pages
http://dx.doi.org/10.1155/2012/538697
Research Article

The Interspinous Spacer: A Clinicoanatomical Investigation Using Plastination

1Department of Orthopaedic and Trauma Surgery, University Hospital of Cologne, Joseph-Stelzmann-Strabße. 9, 50931 Cologne, Germany
2Center of Anatomy, Cologne University, Joseph-Stelzmann-Straße 9, 50931 Cologne, Germany

Received 23 January 2012; Accepted 23 April 2012

Academic Editor: Justin S. Smith

Copyright © 2012 Thomas Kaulhausen 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

Purpose. The relatively new and less-invasive therapeutic alternative “interspinous process decompression device (IPD)” is expected to result in improved symptoms of neurogenic intermittent claudication (NIC) caused by lumbar spinal stenosis. The aim of the study was to analyze IPD position particularly regarding damage originating from surgical implantation. Methods. Anatomic assessments were performed on a fresh human cadaver. For the anatomic examination, the lumbar spine was plastinated after implantation of the IPDs. After radiographic control, serial 4 mm thick sections of the block plastinate were cut in the sagittal (L1–L3) and horizontal (L3–L5) planes. The macroanatomical positioning of the implants was then analyzed. The insertion procedure caused only little injury to osteoligamentous or muscular structures. The supraspinous ligament was completely intact, and the interspinous ligaments were not torn as was initially presupposed. No osseous changes at the spinal processes were apparent. Contact of the IPD with the spinous processes was visible, so that sufficient biomechanical limitation of the spinal extension seems likely. Conclusions. Minimally invasive IPD implantation with accurate positioning in the anterior portion of the interspinous place is possible without severe surgical trauma.