title: Fusion after interspinous device placement.
abstract: Lumbar interspinous devices are intended to unload the facet joints, restore foraminal height, lower intradisk pressure, and provide motion-preserving stabilization. They are an alternative treatment for patients with spinal degeneration and have increased in popularity in recent years. To the authors' knowledge, heterotopic ossification has not been previously reported around an interspinous device, and this is the first reported case of interspinous fusion after interspinous device placement.A 66-year-old man presented with a 3-year history of low back pain and a 4-month history of radiating pain down his left leg. A diagnosis was made of lumbar spinal stenosis and left disk herniation at L4-L5 after physical and imaging examinations. A dynamic interspinous device was implanted after the decompressive surgery. The patient's symptoms were relieved postoperatively. Thirty-two months later, he returned with back pain after being in a traffic accident. Lumbar radiographs showed a massive bony formation around the implant. Radiographs and a computed tomography scan 4.5 years later revealed that the implanted device segments were fused. No implant motion was seen on dynamic radiographs. Because the patient was symptom free, no interventions were performed.Heterotopic bone formation around a dynamic interspinous device may hamper motion preservation, and heterotopic ossification is a potential mid- and long-term complication.
authors.affiliation: Department of Orthopaedic Surgery, Second Affiliated Hospital of Wenzhou Medical College, 109 Xueyuanxi Rd, Wenzhou 325000, China. tiannaifeng@163.com
authors.forename: Nai-Feng
authors.initials: NF
authors.lastname: Tian
authors.forename: Xiao-Lei
authors.initials: XL
authors.lastname: Zhang
authors.forename: Yao-Sen
authors.initials: YS
authors.lastname: Wu
authors.forename: Li-Bo
authors.initials: LB
authors.lastname: Jiang
authors.forename: Hua-Zi
authors.initials: HZ
authors.lastname: Xu
authors.forename: Yong-Long
authors.initials: YL
authors.lastname: Chi
mesh_terms: D000368:Aged; D019299:Decompression, Surgical / Q000295:instrumentation; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000601:surgery; D007796:Laminectomy / Q000295:instrumentation* / Q000379:methods; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D008297:Male; D009999:Ossification, Heterotopic / Q000000981:diagnostic imaging / Q000209:etiology*; D019736:Prostheses and Implants; D013122:Spinal Diseases / Q000000981:diagnostic imaging / Q000209:etiology*; D014057:Tomography, X-Ray Computed