Midterm Clinical and Radiologic Outcomes after Percutaneous Interspinous Spacer Treatment for Neurogenic Intermittent...

Area of Science:

• Neurosurgery
• Orthopedic Surgery
• Minimally Invasive Spine Procedures

Background:

• Neurogenic intermittent claudication (NIC) is a debilitating condition often resulting from lumbar spinal stenosis.
• Conservative treatments for NIC frequently fail, necessitating alternative interventions.
• Percutaneous interspinous process spacer (IPS) implantation is an option for patients with refractory NIC.

Purpose of the Study:

• To assess the midterm clinical and radiologic outcomes of percutaneous interspinous process spacer (IPS) treatment for neurogenic intermittent claudication (NIC).
• To evaluate the durability of treatment effects in patients who have not responded to conservative management.

Main Methods:

• A cohort of 80 patients with confirmed lumbar spinal stenosis and failed conservative treatment underwent percutaneous IPS implantation.
• Clinical outcomes were measured using Visual Analog Scale (VAS) for pain and Oswestry Disability Index (ODI) for function at baseline and up to 3 years post-procedure.
• Radiologic changes, including spinal canal and foraminal cross-sectional areas, were assessed using computed tomography at baseline and 1 year.

Main Results:

• Percutaneous IPS treatment led to significant reductions in VAS and ODI scores at 1 month, with sustained improvements at 1 and 3 years.
• The mean VAS score decreased from 8.1 to 4.4, and the mean ODI score decreased from 23.3 to 11.7.
• Radiologic evaluation at 1 year showed a significant 15% increase in spinal canal and foraminal cross-sectional areas at the treated level.

Conclusions:

• Percutaneous interspinous process spacer (IPS) implantation provides significant and durable pain relief and functional improvement for patients with neurogenic intermittent claudication (NIC) refractory to conservative care.
• The observed clinical benefits are associated with measurable increases in spinal canal and foraminal dimensions, suggesting a mechanism for improved neuroforaminal decompression.