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European Spine Journal

Erschienen in:

01.11.2009 | Original Article

The short- and mid-term effect of dynamic interspinous distraction in the treatment of recurrent lumbar facet joint pain

verfasst von: Mario Cabraja, Alexander Abbushi, Christian Woiciechowsky, Stefan Kroppenstedt

Erschienen in: European Spine Journal | Ausgabe 11/2009

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Abstract

Owing to failure to achieve positive long-term effects, the currently performed treatment methods for lumbar facet joint syndrome (LFJS) are still under debate. Interspinous distraction devices unload the facet joints. Thus, these devices might be an alternative surgical treatment method for LFJS. The aim of this study was to evaluate the clinical and radiological outcome of an interspinous distraction device for the treatment of LFJS. Subjects had verified single level LFJS at level L4–5. They received percutaneous facet joint denervation (PFJD). If pain persisted, they were offered implantation of an interspinous device (Coflex) and/or repeat PFJD. Clinical and radiological outcome was determined before and after PFJD or surgery up to 2 years afterwards in all cases. Forty-one patients with LFJS at L4–5 underwent PFJD. Twenty patients with persisting pain underwent a subsequent surgery for implantation of an interspinous device. Five patients with recurrent pain at 6–12 months opted for an additional PFJD. Three obese patients (body weight >100 kg) had persistent pain at 3 months after surgery and received additionally dorsal semi-dynamic stabilization. The clinical outcome improved significantly in the surgically treated patients; however, it did not differ compared with patients receiving PFJD only after 24 months. Radiological evaluation revealed a restricted range of motion (ROM) of the operated and an elevated ROM of the adjacent segment. Surgical or device-related complications were not observed. In conclusions, the implantation of an interspinous Coflex device in case of recurrent facet joint pain succeeds to improve facet joint pain in clinical short-and mid-term settings. However, it does not exceed the outcome of denervated patients.

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Titel: The short- and mid-term effect of dynamic interspinous distraction in the treatment of recurrent lumbar facet joint pain
verfasst von: Mario Cabraja
Alexander Abbushi
Christian Woiciechowsky
Stefan Kroppenstedt
Publikationsdatum: 01.11.2009
Verlag: Springer-Verlag
Erschienen in: European Spine Journal / Ausgabe 11/2009
Print ISSN: 0940-6719
Elektronische ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-009-1149-8

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