title: Midterm Clinical and Radiologic Outcomes after Percutaneous Interspinous Spacer Treatment for Neurogenic Intermittent Claudication.
abstract: OBJECTIVE
  To evaluate the midterm clinical and radiologic outcome of percutaneous interspinous process spacer (IPS) treatment for neurogenic intermittent claudication (NIC) in patients who fail conservative treatment.
  
  
  METHODS
  Consecutive patients with NIC, lumbar spinal stenosis confirmed on magnetic resonance imaging, failure of conservative management for at least 6 months, and treatment with percutaneous IPS were included. Visual analog scale (VAS) and Oswestry Disability Index (ODI) scores were recorded at baseline, 1 month, 1 year and 3 years after treatment. Spinal canal and foraminal cross-sectional areas were calculated from multidetector computed tomography at baseline and 1 year.
  
  
  RESULTS
  There were 80 patients treated with 94 IPS devices; 83% of patients received a single IPS; 78% of IPS devices were placed at L4-L5. An IPS dislocation was the single periprocedural major complication. VAS score of 8.1 ± 2 before treatment was reduced to 4.4 ± 2 at 1 month after treatment (P = .0001); ODI score of 23.3 ± 10 before treatment was reduced to 11.7 ± 8.5 at 1 month after treatment (P = .0001). These significant reductions were durable at 1-year and 3-year follow-up evaluations (P < .01). Spinal canal and foraminal cross-sectional area increased by 15% at 1 year (P = .0001).
  
  
  CONCLUSIONS
  Patients with NIC who failed conservative treatment and were treated with percutaneous IPS achieved significant gains in pain relief and reduced disability that remained durable at 3-year clinical follow-up evaluation. This outcome was accompanied by significant increases in spinal canal and foraminal cross-sectional areas at the treated level.
authors.affiliation: Department of Radiology, SS. Trinità Hospital, Cagliari, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Marcia
authors.affiliation: Neuroendovascular Program, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
authors.forename: Joshua A
authors.initials: JA
authors.lastname: Hirsch
authors.affiliation: Neurovascular Surgery and Neuroradiology Services, Monash Health, Monash University, Melbourne, Australia.
authors.forename: Ronil V
authors.initials: RV
authors.lastname: Chandra
authors.affiliation: Interventional Radiology, Villa Maria Hospital, Turin, Italy.
authors.forename: Mariangela
authors.initials: M
authors.lastname: Marras
authors.affiliation: Department of Radiology, SS. Trinità Hospital, Cagliari, Italy.
authors.forename: Emanuele
authors.initials: E
authors.lastname: Piras
authors.affiliation: Interventional Radiology, Villa Maria Hospital, Turin, Italy.
authors.forename: Giovanni Carlo
authors.initials: GC
authors.lastname: Anselmetti
authors.affiliation: Department of Neuroradiology, Ospedale Cardarelli, Naples, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Muto
authors.affiliation: Department of Radiology, Azienda Ospedaliero Universitaria (A.O.U.), di Cagliari-Polo di Monserrato s.s. 554 Monserrato, Cagliari 09045, Italy. Electronic address: lucasaba@tiscali.it.
authors.forename: Luca
authors.initials: L
authors.lastname: Saba
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019299:Decompression, Surgical / Q000295:instrumentation* / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007383:Intermittent Claudication / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015641:Radiography, Interventional / Q000379:methods*; D013130:Spinal Stenosis / Q000150:complications* / Q000000981:diagnostic imaging / Q000628:therapy*; D059145:Total Disc Replacement / Q000295:instrumentation* / Q000379:methods; D016896:Treatment Outcome