title: Percutaneous interspinous spacer versus open decompression: a 2-year follow-up of clinical outcome and quality of life.
abstract: OBJECTIVE
  Percutaneous interspinous stand-alone spacers offer a simple and effective technique to treat lumbar spinal stenosis with neurogenic claudication. Nonetheless, open decompressive surgery remains the standard of care. This study compares the effectiveness of both techniques and the validity of percutaneous interspinous spacer use.
  
  
  METHODS
  Forty-five patients were included in this open prospective non-randomized study, and treated either with percutaneous interspinous stand-alone spacers (Aperius(®)) or bilateral open microsurgical decompression at L3/4 or L4/5. Patient data, operative data, COMI, SF-36, PCS and MCS, ODI, and walking distance were collected 6 weeks, 3, 6, 9, 12, and 24 months post-surgery.
  
  
  RESULTS
  Group 1 (n = 12) underwent spacer implantation, group 2 (n = 33) open decompression. Five patients from group 1 required implant removal and open decompression during follow-up (FU); one patient was lost to FU. From group 2, seven patients were lost to FU. Remaining patients were assessed as above. After 2 years, back pain, leg pain, ODI, and quality of life improved significantly for group 2. Remaining group 1 patients (n = 6) reported worse results. Walking distance improved for both groups.
  
  
  CONCLUSIONS
  Decompression proved superior to percutaneous stand-alone spacer implantation in our two observational cohorts. Therapeutic failure was too high for interspinous spacers.
authors.affiliation: Department of Orthopedic and Trauma Surgery, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany, frank.beyer@uk-koeln.de.
authors.forename: F
authors.initials: F
authors.lastname: Beyer
authors.forename: A
authors.initials: A
authors.lastname: Yagdiran
authors.forename: P
authors.initials: P
authors.lastname: Neu
authors.forename: T
authors.initials: T
authors.lastname: Kaulhausen
authors.forename: P
authors.initials: P
authors.lastname: Eysel
authors.forename: R
authors.initials: R
authors.lastname: Sobottke
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019299:Decompression, Surgical / Q000009:adverse effects / Q000379:methods* / Q000592:standards; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017116:Low Back Pain / Q000601:surgery; D008297:Male; D008866:Microsurgery / Q000295:instrumentation / Q000379:methods / Q000592:standards; D008875:Middle Aged; D011446:Prospective Studies; D019919:Prosthesis Implantation / Q000009:adverse effects / Q000379:methods* / Q000592:standards; D011788:Quality of Life; D015203:Reproducibility of Results; D013130:Spinal Stenosis / Q000601:surgery*; D016896:Treatment Outcome