Lumbar Interspinous and Interlaminar Instrumentation

Interspinous Instrumentation

Spinal stenosis is a common affliction of individuals 60 years of age or older. It is resultant of chronic degeneration of spinal discs and involves the correlating effects. Among these is bone enlargement due to abnormal friction between the facet joints of the posterior spine, causing pressure on the nerves. Additionally, the ligaments which run between the bones of the spine are anatomically designed to be stretched and rigid, however due to compression no longer maintain their stretched form. The widening of these ligaments causes narrowing of the space for the nerve to pass through. Finally, spinal stenosis is related to the natural bulge of the disc rims which occurs from compression. These components contribute to spinal stenosis collectively.

In regard to treatment for spinal stenosis, interspinous ligament devices have recently gained traction as an alternative to spinal fusion. It is additionally used in combination with surgery to increase effectiveness. Interspinous ligament devices are designed to stretch the ligament between the bones of the spine. This process restores their original height and relieve compression.

Interlaminar Instrumentation

During the insertion of interlaminar instrumentation, diseased bone and ligament tissue surrounding the nerve(s) is removed. A U-shaped device called a Coflex is then inserted between the spinous processes. This provides support, restores height, and opens the foramen. This procedure is appropriate for patients who experience localized spinal stenosis, resulting in limited compression and instability.