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The Italian Renaissance – spacer style
  1. Junjian Huang1,
  2. John Shin2,
  3. Stefano Marcia3,
  4. Allan L Brook4
  1. 1 Radiology, Massachusetts General Hospital, Boston, Massachusetts, USA
  2. 2 Neurosurgery, Massachusetts General Hospital, Boston, Massachusetts, USA
  3. 3 Radiology, SS Trinità Hospital ASSL Cagliari ATS Sardegna, Cagliari, Italy
  4. 4 Radiology, Montefiore Medical Center, Bronx, New York, USA
  1. Correspondence to Dr Junjian Huang, Radiology, Massachusetts General Hospital, Boston, MA 02114, USA; JHUANG43{at}

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This volume of JNIS features Manfre et al 1 describing a single center series looking at the use of percutaneous interspinous devices (PID) over a 9-year period. In addition to the impressive size of the cohort as well as protracted follow-up, the article delves into an area not routinely acknowledged in prior series, that is, the use of adjunctive spinoplasty.2 In this series, 688 patients underwent PID placement for high-grade spinal stenosis recalcitrant to conservative management and 432 of these patients had PMMA placed in adjacent spinous processes, aka, spinoplasty. Patients in both cohorts did very well in terms of pain and disability scores with decreased symptom recurrence in the spinoplasty group. Of note, the 29 patients that suffered a symptom recurrence treated with spacer alone were typically noted to have a spinous process fracture or bony remodeling around the PID leading to the recurrence of lumbar spinal stenosis. The results of this study help to further establish the role of PID use in lumbar spinal stenosis.

Introduced in the mid-1980s, interspinous devices were designed to provide dynamic vertebral fixation with a goal of reproducing physiologic spinal kinetics. Initially, devices such as the Wallis Implant were used as surgical supplements and routinely performed in conjunction with open surgery for low back pain.3 …

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  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial, or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; internally peer reviewed.

  • Data availability statement No data are available. NA.

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