Turkish Neurosurgery
Can Interspinous Device, SPIRE™, Be An Alternative Fixation Modality in Posterior Lumbar Fusion Instead of Pedicle Screw?
Chang-Hyun Lee2, Seung-Jae Hyun1, Ki-Jeong Kim1, Tae-Ahn Jahng1, Hyun-Jib Kim1
1Seoul Natl. Univ. Bundang Hospital, Neurosurgery, Seongnam,
2Ilsan Paik Hospital, Inje University College of Medicine, Neurosurgery, Goyang,
DOI: 10.5137/1019-5149.JTN.16097-15.1

Aim:Although conventional posterior lumbar interbody fusion (PLIF) using pedicle screws accomplish successful outcomes, pedicle screw related complications were sometimes noted. SPIRE™ was invented as interspinous fixation device (ISD) to replace pedicle screw. This study is to evaluate the clinical and radiological outcomes in patients underwent unilateral PLIF using SPIRE™ compared with pedicle screw.Material and Methods:All consecutive patients who shows medically intractable lumbar degenerative disease with unilateral radiculopathy and mild instability were enrolled. Thirteen patients underwent the PLIF using SPIRE™ (ISD group), and age, gender, and index level matched patients underwent the PLIF using pedicle screw (PS group) were recruited as 1:1 ratio. Pain, Oswestry Disability Index (ODI), disc height, and slippage were evaluated. Results:Both PS and ISD groups revealed significant improvement and there was no significant difference between them (back pain, p=0.18; leg pain, p=0.51; ODI, p=0.82). Although the ISD group showed spondylolisthesis for the first 3 months after the surgery, there is no significant difference compared with the PS group (p=0.65). Disc height decreased in both the ISD group (10.8mm→7.7mm) and the PS group (12.8mm→10.8mm), and this difference had statistical significance (p<0.01). In aspect of perioperative outcomes, the ISD group displayed better outcomes than the PS group (blood loss, p<0.001; surgery time, p=0.017). Conclusion:SPIRE fixation for PLIF demonstrate a comparable clinical outcomes with pedicle screw. It may be weak to fix, but acceptable. This technique may be an alternative technique to the patients with unilateral radiculopathy and mild instability.

Corresponding author : Hyun-Jib Kim