Interspinous Stabilisation

What is it?

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Dynamic spinal stabilisation is based on the concept of restricting movement of spinal segments rather than preventing all movement. It aims to restrict movements in the directions that may cause pain, nerve impingement or instability, but allows movement in other directions. Dynamic spinal stabilisation can achieve spinal stability and prevent diseases of adjacent segments without requiring fusion.

Interspinous dynamic stabilisation, a type of dynamic spinal stabilisation, is a technique that involves the insertions of devices into the interspinous space that distract and hold them in a more favourable position.

The spinous processes are located at the very back of the spinal column, just beneath the skin.  The procedure is therefore much less invasive than fusion surgery and particularly beneficial for patients at high risk.  In well selected patients, this operation can have very good results.

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What happens on the day?

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The operation is performed under general anaesthetic and we therefore ask patients to refrain from eating or drinking anything for 6 hours prior to the injection.  Water however is allowed up to 2 hours before admission.  

Upon admission, the patient will be seen by the ward nurse, the anaesthetist and Mr. Lau himself.  Informed consent will be obtained and a mark placed on the back to confirm the correct site of the operation. The patient will be given a general anaesthetic and carefully positioned on their front for the operation which will be guided by a specialised X-ray machine.

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A 2 inch incision is made directly over the interspinous space. The implant is inserted and, as with the Wallis implant, bands are passed around the spinous process above and below to allow further stability. 

Patients will  wake up in the recovery area and can mobilise immediately following surgery.  Discharge is either on the same day or the day following with advice regarding activities.
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Follow up

Typically, a routine follow-up appointment is made for 6 weeks.  One significant advantage of this operation compared to fusion surgery is that it can be easily reversed by removing the implant or converting to a fusion procedure.
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