A review of interspinous fusion devices: High complication, reoperation rates, and costs with poor outcomes

Surg Neurol Int. 2012;3:7. doi: 10.4103/2152-7806.92172. Epub 2012 Jan 21.

Abstract

Background: Interspinous fusion devices (IFDs) are increasingly offered to patients over the age of 50 with lumbar spinal stenosis and intermittent neurogenic claudication. Here, we review the literature on complication rates, reoperation rates, and outcomes for implanting IFD, and offer an assessment of IFD charges at a single institution in 2010.

Methods: The literature concerning IFD implants was reviewed with particular attention focused on complications, reoperation rates, and outcomes. Additionally, the costs of implanting 31 IFD devices in 16 patients at one to three levels at a single institution in 2010 are presented.

Results: Reviewing the spinal literature concerning the postoperative status of IFD followed over an average of 23-42.9 postoperative months revealed that IFD resulted in 11.6-38% complication rate, 4.6-85% reoperation rate, and 66.7-77% frequency of poor outcomes. Additionally, the 31 devices implanted in 16 patients at a single university hospital in 2010 cost a total of $576,407.

Conclusions: With high maximal complication rates (38%), reoperation rates (85%), poor outcomes (77%), and high costs ($576,407 for 31 devices in 16 patients), the utilization and implantation of IFD remains extremely controversial and should be investigated further.

Keywords: Complications; high costs; interspinous fusion devices; lumbar stenosis; poor outcomes; reoperations.