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2015 ; 7
(3
): 323-9
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A Systematic Review of Interspinous Dynamic Stabilization
#MMPMID26330954
Lee SH
; Seol A
; Cho TY
; Kim SY
; Kim DJ
; Lim HM
Clin Orthop Surg
2015[Sep]; 7
(3
): 323-9
PMID26330954
show ga
BACKGROUND: A systematic literature review of interspinous dynamic stabilization,
including DIAM, Wallis, Coflex, and X-STOP, was conducted to assess its safety
and efficacy. METHODS: The search was done in Korean and English, by using eight
domestic databases which included KoreaMed and international databases, such as
Ovid Medline, Embase, and the Cochrane Library. A total of 306 articles were
identified, but the animal studies, preclinical studies, and studies that
reported the same results were excluded. As a result, a total of 286 articles
were excluded and the remaining 20 were included in the final assessment. Two
assessors independently extracted data from these articles using predetermined
selection criteria. Qualities of the articles included were assessed using
Scottish Intercollegiate Guidelines Network (SIGN). RESULTS: The complication
rate of interspinous dynamic stabilization has been reported to be 0% to 32.3% in
3- to 41-month follow-up studies. The complication rate of combined interspinous
dynamic stabilization and decompression treatment (32.3%) was greater than that
of decompression alone (6.5%), but no complication that significantly affected
treatment results was found. Interspinous dynamic stabilization produced slightly
better clinical outcomes than conservative treatments for spinal stenosis. Good
outcomes were also obtained in single-group studies. No significant difference in
treatment outcomes was found, and the studies compared interspinous dynamic
stabilization with decompression or fusion alone. CONCLUSIONS: No particular
problem was found regarding the safety of the technique. Its clinical outcomes
were similar to those of conventional techniques, and no additional clinical
advantage could be attributed to interspinous dynamic stabilization. However, few
studies have been conducted on the long-term efficacy of interspinous dynamic
stabilization. Thus, the authors suggest further clinical studies be conducted to
validate the theoretical advantages and clinical efficacy of this technique.
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