Kaifeng Wang and Zhenqi Zhu contributed equally to this work.
The authors declare that they have no competing interests.
WK and ZZ carried out study design and data acquisition. WB participated in manuscript editing. ZY carried out definition of intellectual content. LH carried out literature research. All authors had read and approved the final manuscript.
Dynamic interspinous stabilization devices generally provide satisfactory results, but can result in recurrent lumbar disc herniation, spinous process fracture, or bone resorption of the spinous process. The purpose of this study was to investigate if the Wallis dynamic stabilization device is associated with bone resorption.
Patients who underwent single-segment posterior lumbar decompression and implantation of a Wallis dynamic interspinous stabilization device at the L4/5 level between January 1, 2009 and October 1, 2011 were included. Bone resorption rate, Oswestry Disability Index (ODI), Japanese Orthopedic Association (JOA) score, and visual analogue scale (VAS) pain score were measured. Patient baseline and 1-year follow-up data were collected and analyzed. The bone resorption rate of the L4 and L5 spinous processes was calculated.
Twenty four males and 20 females with a mean age of 42.7 ± 14.7 years were included. Twenty nine patients had significant bone resorption (bone resorption rate > 20%) and 15 had no bone resorption (bone resorption rate ≤ 20%) at 1 year after surgery. Lumbar lordosis ≥ 50° was associated with a lower bone resorption than lumbar lordosis < 50° and increasing BMI was associated with increased bone resorption. There were no significant differences between the bone resorption and no bone resorption groups in the improvement rate of VAS pain score, ODI, and JOA score at 1 year after surgery.
Significant bone resorption occurs within 1 year after implantation of the Wallis device in more than 50% of patients. However, it does not affect short-term functional results.
Whitecloud TS, Davis JM, Olive PM. Operative treatment of the degenerated segment adjacent to a lumbar fusion. Spine (Phila Pa 1976). 1994;19:531–6. CrossRef
Biering-Sørensen F, Hansen FR, Schroll M, Runeborg O. The relation of spinal x-ray to low-back pain and physical activity among 60-year-old men and women. Spine (Phila Pa 1976). 1985;10:445–51. CrossRef
Yang KH, King AI. Mechanism of facet load transmission as a hypothesis for low-back pain. Spine (Phila Pa 1976). 1984;9:557–65. CrossRef
Senegas J, Etchevers JP, Vital JM, Baulny D, Grenier F. Recalibration of the lumbar canal, an alternative to laminectomy in the treatment of lumbar canal stenosis]. Chir Orthop Reparatrice Appar Mot. 1988;74:15–22 [Article in French].
Liu HY, Zhou J, Wang B, Wang HM, Jin ZH, Zhu ZQ, et al. Comparison of Topping-off and posterior lumbar interbody fusion surgery in lumbar degenerative disease: a retrospective study. Chin Med J (Engl). 2012;125:3942–6.
Chung KJ, Hwang YS, Koh SH. Stress fracture of bilateral posterior facet after insertion of interspinous implant. Spine (Phila Pa 1976). 2009;34:E380–3. CrossRef
Ghiselli G, Wang JC, Hsu WK, Dawson EG. L5-S1 segment survivorship and clinical outcome analysis after L4-L5 isolated fusion. Spine (Phila Pa 1976). 2003;28:275–80. CrossRef
McPhee B. Spondylolishthesis and spondylolysis. In: Youmans JR, editor. Neurological surgery: a comprehensive reference guide to the diagnosis and management of neurosurgical problems, Philadelphia: WB Saunders, vol. 27. 3rd ed. 1990. p. 49–84.
Yang Z, Griffith JF, Leung PC, Lee R. Effect of osteoporosis on morphology and mobility of the lumbar spine. Spine (Phila Pa 1976). 2009;34:E115–1. CrossRef
Ma XY, Yin QS, Wu ZH, Xia H, Riew KD, Liu JF. C2 anatomy and dimensions relative to translaminar screw placement in an Asian population. Spine (Phila Pa 1976). 2010;35(6):704–8. CrossRef
Griffith JF, Wang YX, Antonio GE, Choi KC, Yu A, Ahuja AT. Modified Pfirrmann grading system for lumbar intervertebral disc degeneration. Spine (Phila Pa 1976). 2007;32:E708–12. CrossRef
Kabir SM, Gupta SR, Casey AT. Lumbar interspinous spacers: a systematic review of clinical and biomechanical evidence. Spine (Phila Pa 1976). 2010;35:E1499-–506. CrossRef
Lafage V, Gangnet N, Sénégas J, Lavaste F, Skalli W. New interspinous implant evaluation using an in vitro biomechanical study combined with a finite-element analysis. Spine (Phila Pa 1976). 2007;32:706–13. CrossRef
Chiba M. Study of bone remodeling mechanism induced by mechanical stress. Differentiation of osteoclasts induced by compressive force in newborn rat cultured long bone. Nihon Kyosei Shika Gakkai Zasshi 1989;48:585-600. [Article in Japanese].
Tanne K, Nagataki T, Matsubara S, Kato J, Terada Y, Sibaguchi T, et al. Association between mechanical stress and bone remodeling. J Osaka Univ Dent Sch. 1990;30:64–71. PubMed
Takuma M, Tsutsumi S, Tsukamoto H, Kimura Y, Fukunaga S, Takamori Y, et al. The influence of materials difference on stress distribution and bone remodeling around alumina and titanium dental implants. J Osaka Univ Dent Sch. 1990;30:86–96. PubMed
Enis F. The three column spine and its significance in the classification of acute thoracolumbar spinal injuries. Spine (Phila Pa 1976). 1983;8:817–31. CrossRef
Schulte LM, O’Brien JR, Matteini LE, Yu WD. Change in sagittal balance with placement of an interspinous spacer. Spine (Phila Pa 1976). 2011;36(20):E1302–5. CrossRef
Gurban CV, Mederle O. The OPG/RANKL system and zinc ions are promoters of bone remodeling by osteoblast proliferation in postmenopausal osteoporosis. Rom J Morphol Embryol. 2011;52(3 Suppl):1113–9. PubMed
- Bone resorption during the first year after implantation of a single-segment dynamic interspinous stabilization device and its risk factors
- BioMed Central
Neu im Fachgebiet Orthopädie und Unfallchirurgie
Mail Icon II