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Dimensions of the spinous process and interspinous space: a morphometric study

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Abstract

Purpose

To measure the morphological dimensions of the spinous process (SP) and interspinous space, and provide a basis for the development of interspinous devices for the Korean or East Asian populations.

Methods

We retrospectively analyzed the anatomical parameters of 120 patients. The parameters included height, length, and width of SP, interspinous distance (supine, standing, and dynamic), cortical thickness of SP, and spino-laminar (S-L) angle. Correlations between measurements, age, and gender were investigated.

Results

The largest height, length, and cortical thickness and S-L angle were noted at L3. The largest width was observed at S1. The interspinous distance decreased significantly from L2–3 to L5–S1 and was significantly larger in the supine than in standing posture for L5–S1. Cortical thickness was gradually tapered from the anterior to the posterior position. The S-L angle at L2 and L3 was similar and significantly decreased from L3 to S1. An increased trend in width with aging and a decreased trend in distance (supine) were noted. A significant increase in height, length, and distance in males compared with females was also observed.

Conclusions

The interspinous space is wider at the anterior, and the cortex is thicker anteriorly. Accordingly, it appears that the optimized implant position lies in the interspinous space anteriorly. The varying interspinous space with different postures and gradually narrowing with age suggest the need for caution when sizing the device. Gender differences also need to be considered when designing implantable devices.

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References

  1. Albietz JS, Rosasarellano P, Fleming JC, Gurr KR, Bailey SI, Bailey CS (2012) An anatomic study of the interspinous space of the lumbosacral spine. Eur Spine J 21:145–148

    Article  Google Scholar 

  2. Anderson PA, Tribus CB, Kitchel SH (2006) Treatment of neurogenic claudication by interspinous decompression: application of the X STOP device in patients with lumbar degenerative spondylolisthesis. J Neurosurg Spine 4:463–471

    Article  Google Scholar 

  3. Bono CM, Vaccaro AR (2007) Interspinous process devices in the lumbar spine. J Spinal Disord Tech 20:255–261

    Article  Google Scholar 

  4. Bowers C, Amini A, Dailey AT, Schmidt MH (2010) Dynamic interspinous process stabilization: review of complications associated with the X-Stop device. Neurosurg Focus 28:E8

    Article  Google Scholar 

  5. Chen PG, Daubs MD, Berven S et al (2016) Surgery for degenerative lumbar scoliosis: the development of appropriateness criteria. Spine (Phila Pa) 41:910–918

    Article  Google Scholar 

  6. Fransen P (2017) Long-term results with percutaneous interspinous process devices in the treatment of neurogenic intermittent claudication. J Spine Surg 3:620–623

    Article  Google Scholar 

  7. Gala RJ, Russo GS, Whang PG (2017) Interspinous implants to treat spinal stenosis. Curr Rev Musculoskelet Med 10:182–188

    Article  Google Scholar 

  8. Gazzeri R, Galarza M, Neroni M et al (2015) Failure rates and complications of interspinous process decompression devices: a European multicenter study. Neurosurg Focus 39:E14

    Article  Google Scholar 

  9. Ihm EH, Han IB, Shin DA, Kim TG, Huh R, Chung SS (2013) Spinous process morphometry for interspinous device implantation in Korean patients. World Neurosurg 79:172–176

    Article  Google Scholar 

  10. Kim DH, Albert TJ (2007) Interspinous process spacers. J Am Acad Orthop Surg 15:200–207

    Article  Google Scholar 

  11. Kondrashov DG, Hannibal M, Hsu KY, Zucherman JF (2006) Interspinous process decompression with the X-STOP device for lumbar spinal stenosis: a 4-year follow-up study. J Spinal Disord Tech 19:323–327

    Article  Google Scholar 

  12. Lee HM, Kim NH, Kim HJ, Chung IH (1995) Morphometric study of the lumbar spinal canal in the Korean population. Spine (Phila Pa) 20:1679–1684

    Article  CAS  Google Scholar 

  13. Lurie J, Tomkins-Lane C (2016) Management of lumbar spinal stenosis. BMJ 352:h6234

    Article  Google Scholar 

  14. Mariottini A, Pieri S, Giachi S et al (2005) Preliminary results of a soft novel lumbar intervertebral prothesis (DIAM) in the degenerative spinal pathology. Acta Neurochir Suppl 92:129–131

    Article  CAS  Google Scholar 

  15. Miscusi M, Trungu S, Forcato S, Ramieri A, Polli FM, Raco A (2018) Long-term clinical outcomes and quality of life in elderly patients treated with interspinous devices for lumbar spinal stenosis. J Neurol Surg A Cent Eur Neurosurg 79:139–144

    Article  Google Scholar 

  16. Ortega A, Sarmiento JM, Patil C et al (2015) Comparative analysis of inpatient and outpatient interspinous process device placement for lumbar spinal stenosis. J Neurol Surg A Cent Eur Neurosurg 76:443–450

    Article  Google Scholar 

  17. Phan K, Rao PJ, Ball JR, Mobbs RJ (2016) Interspinous process spacers versus traditional decompression for lumbar spinal stenosis: systematic review and meta-analysis. J Spine Surg 2:31–40

    Article  Google Scholar 

  18. Puzzilli F, Gazzeri R, Galarza M et al (2014) Interspinous spacer decompression (X-STOP) for lumbar spinal stenosis and degenerative disk disease: a multicenter study with a minimum 3-year follow-up. Clin Neurol Neurosurg 124:166–174

    Article  Google Scholar 

  19. Ran B, Li Q, Yu B, Chen X, Guo K (2015) Morphometry of lumbar spinous process via three dimensional CT reconstruction in a Chinese population. Int J Clin Exp Med 8:1129–1136

    PubMed  PubMed Central  Google Scholar 

  20. Richards JC, Majumdar S, Lindsey DP, Beaupré GS, Yerby SA (2005) The treatment mechanism of an interspinous process implant for lumbar neurogenic intermittent claudication. Spine (Phila Pa) 30:744–749

    Article  Google Scholar 

  21. Ross PD, Wasnich RD, Davis JW, Vogel JM (1991) Vertebral dimension differences between Caucasian populations, and between Caucasians and Japanese. Bone 12:107–112

    Article  CAS  Google Scholar 

  22. Siewe J, Selbeck M, Koy T et al (2015) Indications and contraindications: interspinous process decompression devices in lumbar spine surgery. J Neurol Surg A Cent Eur Neurosurg 76:1–7

    PubMed  Google Scholar 

  23. Sobottke R, Koy T, Röllinghoff M et al (2010) Computed tomography measurements of the lumbar spinous processes and interspinous space. Surg Radiol Anat 32:731–738

    Article  Google Scholar 

  24. Verhoof OJ, Bron JL, Wapstra FH, van Royen BJ (2008) High failure rate of the interspinous distraction device (X-Stop) for the treatment of lumbar spinal stenosis caused by degenerative spondylolisthesis. Eur Spine J 17:188–192

    Article  Google Scholar 

  25. Weinstein JN, Tosteson TD, Lurie JD et al (2010) Surgical versus nonoperative treatment for lumbar spinal stenosis four-year results of the spine patient outcomes research trial. Spine (Phila Pa) 35:1329–1338

    Article  Google Scholar 

  26. Wu AM, Zhou Y, Li QL et al (2014) Interspinous spacer versus traditional decompressive surgery for lumbar spinal stenosis: a systematic review and meta-analysis. PloS One 9:e97142

    Article  Google Scholar 

  27. Xu C, Ni WF, Tian NF, Hu XQ, Li F, Xu HZ (2013) Complications in degenerative lumbar disease treated with a dynamic interspinous spacer (Coflex). Int Orthop 37:2199–2204

    Article  Google Scholar 

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Acknowledgements

This material is based upon work supported by the Ministry of Trade, Industry & Energy (MOTIE, Korea) under Industrial Technology Innovation Program. No.10062712, “Development of spinal fusion implant and its manufacturing system; the functionally optimized, patient-customized in terms of bioactive materials to meet the clinical needs”; China Scholarship Council (CSC, no. [2016]3100).

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Authors and Affiliations

  1. Department of Neurosurgery, Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul, Republic of Korea

    Guang-Xun Lin, Tsz-King Suen, Javier Quillo-Olvera, Kutbuddin Akbary, Jung-Woo Hur, Eun Kim & Eun-Jin Park

  2. The Catholic Central Laboratory of Surgery (CCLS) and Department of Neurosurgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero Seocho-gu, Seoul, 06591, Republic of Korea

    Jin-Sung Kim

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  1. Guang-Xun Lin
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  2. Tsz-King Suen
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Correspondence to Jin-Sung Kim.

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All the authors declare that no actual or potential conflict of interest exists. All authors have contributed to the material and preparation of this manuscript.

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Lin, GX., Suen, TK., Quillo-Olvera, J. et al. Dimensions of the spinous process and interspinous space: a morphometric study. Surg Radiol Anat 40, 1383–1390 (2018). https://doi.org/10.1007/s00276-018-2096-z

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  • DOI: https://doi.org/10.1007/s00276-018-2096-z

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