Interspinous Stabilization/Decompression with Viking and In-space Devices in Patients with Degenerative Disk Disease and Spinal Stenosis at a Lumbosacral Level

Introduction In the last few years, several interspinous prostheses have been used for the treatment of several degenerative disk diseases involving the lumbosacral region; among them stenosis of the spinal canal or degenerative discopathy. Such devices share the same characteristics such as they require minimally invasive procedures and are implanted in the stenosis of lumbosacral joint or in the degenerative discopathy with the aim to increase canal diameters or upload the task of the intervertebral disk. In this paper, we present our experience in the implant of some interspinous devices (Viking and In-Space) in lumbosacral degenerative disk disease and lumbar spinal stenosis on a single to double level. AIMS The aim of this study is to verify the clinical results on pain and quality of life measured by the application of VAS scale and ODI index with a follow-up of 12 and 36 months. Also, to evaluate the tolerability of the prosthesis material. Materials and Methods From 2007 to 2010, 150 patients have undergone surgery concerning the interspinous dynamic decompression with Viking and In-Space on a single to double level. Viking is a interspinous prosthesis device made by Peek showing the following features: interspinous dynamic spacer able to absorb axial, flexional and torsional stresses applied on the movement segment involved by its implantation as well as, in the meanwhile, to preserve the degrees of freedom of the segment itself. In-Space is an interspinous prosthesis device made by Peek, intended to stop the segmental extension and to distract the interspinous space at a symptomatic level between L1 to L5. In-Space acts as a space-holder and protects mainly the posterior elements by maintaining the foraminal height, opening up the area of the spinal canal, reducing stress on the facet joints and relieving pressure on the posterior annulus. Treatment with Viking and In-Space was indicated in case of LDDD and LLS (assessed by clinical and radiological examinations) linked or not to osteochondrosis, measured by X-ray or NMR. Flexion/extension X-ray views are strongly recommended. The clinical situation was characterized by chronic lumbar back pain with episodic and irregular pain irradiation to inferior limb measured by using VAS scale and ODI index. Among 150 patients, 62 were men and 88 women, ranging from 32 to 77 years old (mean age 53.81). The site of the surgery has been distributed as shown: single level 130 patients ( L4-L5 67, L5-S1 49, L3-