A Systematic Review of Interspinous Dynamic Stabilization.
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.
Department of Nursing Science, Gachon University, Incheon, Korea.
Seon-Heui
SH
Lee
The Health Insurance Review and Assessment Service, Seoul, Korea.
Aram
A
Seol
Department of Neurosurgery, Korea University Hospital, Seoul, Korea.
Tae-Young
TY
Cho
Department of Family Medicine, Hallym University Kangdong Sacred Heart Hospital, Seoul, Korea.
Soo-Young
SY
Kim
Department of Orthopedic Surgery, Ewha Womans University Hospital, Seoul, Korea.
Dong-Jun
DJ
Kim
Department of Orthopedic Surgery, Ewha Womans University Hospital, Seoul, Korea.
Hyung-Mook
HM
Lim
D019299:Decompression, Surgical; D006801:Humans; D011183:Postoperative Complications; D013123:Spinal Fusion / Q000009:adverse effects / Q000379:methods; D013130:Spinal Stenosis / Q000503:physiopathology / Q000601:surgery
Review; Spinal stenosis; Spine; Therapeutics