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Research ArticleNew Technology

Comparison of Adverse Outcomes Following Placement of Superion Interspinous Spacer Device Versus Laminectomy and Laminotomy

Lindsay Welton, Brandi Krieg, Deepa Trivedi, Rahwa Netsanet, Nolan Wessell, Andriy Noshchenko and Vikas Patel
International Journal of Spine Surgery February 2021, 8020; DOI: https://doi.org/10.14444/8020
Lindsay Welton
1University of Minnesota School of Medicine Department of Surgery, Division of General Surgery, Minneapolis, Minnesota
MD
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Brandi Krieg
2University of Colorado School of Medicine, Aurora, Colorado
BS
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Deepa Trivedi
3University of Colorado School of Public Health, Aurora, Colorado
BS
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Rahwa Netsanet
4University of Colorado School of Medicine Department of Orthopedic Surgery, Division of Spine Surgery, Aurora, Colorado
BS
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Nolan Wessell
4University of Colorado School of Medicine Department of Orthopedic Surgery, Division of Spine Surgery, Aurora, Colorado
MD
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Andriy Noshchenko
4University of Colorado School of Medicine Department of Orthopedic Surgery, Division of Spine Surgery, Aurora, Colorado
PHD
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Vikas Patel
4University of Colorado School of Medicine Department of Orthopedic Surgery, Division of Spine Surgery, Aurora, Colorado
MD
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ABSTRACT

Background Current evidence suggests placement of the Superion interspinous spacer (SISS) device compared with laminectomy or laminotomy surgery offers an effective, less invasive treatment option for patients with symptomatic lumbar spinal stenosis. Both SISS placement and laminectomy or laminotomy have risks of complications and a direct comparison of complications between the 2 procedures has not been previously studied. The purpose of this study is to compare the short-term complications of the SISS with laminectomy or laminotomy and highlight device-specific long-term outcomes with SISS.

Methods Via retrospective review, 189 patients who received lumbar level SISSs were compared with 378 matched controls who underwent primary lumbar spine laminectomy or laminotomy; data were collected from the American College of Surgeons National Surgical Quality Improvement Program database. Complications analyzed included rates of wound infection, pulmonary embolism, deep venous thrombosis, urinary tract infection, sepsis, septic shock, cardiac arrest, death, and reoperation within 30 days of index surgery. Differences between groups were analyzed using the χ2test. Device-specific complication (DSC) rates included device malfunction or misplacement (DM), device explantation (DE), spinous process fracture (SPF), and subsequent spinal surgery (SSS).

Results No differences in demographics or comorbidities existed between groups. There was no significant difference in rates of complications between groups. A total of 44.4% of patients in the SISS group experienced DSCs with 11.1% of patients experiencing DM, 21.1% experiencing an SPF, 20.1% requiring DE, and 24.3% requiring SSS. Having at least 1 DSC significantly increased odds of SSS, odds ratio >120, P < .0001.

Conclusion Rates of 30-day complications in the SISS group were not significantly different from patients undergoing laminectomy or laminotomy. Rates of 2-year DSC within SISS and cumulative risk associated with these complications should be considered further as they likely represent need for additional procedures for patients and substantial cost to the healthcare system.

Level of Evidence 4.

Clinical Relevance Having no differences in adverse events between laminectomies or laminotomies and SISS plus evidence of substantial device-specific long-term adverse outcomes and reoperation should be given consideration when deciding on surgical intervention of 1-2 level lumbar spinal stenosis.

  • laminectomy
  • laminotomy
  • interspinous spacer

Footnotes

  • Disclosures and COI: The authors have no relevant disclosures as it pertains to the content discussed in this study. Data regarding patients who received the Superion Interspinous Spacer were provided by Vertiflex, Inc (Carlsbad, California). However, the company had no hand in study design, data analysis, statistical review, or manuscript production.

  • This manuscript is generously published free of charge by ISASS, the International Society for the Advancement of Spine Surgery. Copyright © 2021 ISASS
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International Journal of Spine Surgery: 19 (S2)
International Journal of Spine Surgery
Vol. 19, Issue S2
1 Apr 2025
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Comparison of Adverse Outcomes Following Placement of Superion Interspinous Spacer Device Versus Laminectomy and Laminotomy
Lindsay Welton, Brandi Krieg, Deepa Trivedi, Rahwa Netsanet, Nolan Wessell, Andriy Noshchenko, Vikas Patel
International Journal of Spine Surgery Feb 2021, 8020; DOI: 10.14444/8020

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Comparison of Adverse Outcomes Following Placement of Superion Interspinous Spacer Device Versus Laminectomy and Laminotomy
Lindsay Welton, Brandi Krieg, Deepa Trivedi, Rahwa Netsanet, Nolan Wessell, Andriy Noshchenko, Vikas Patel
International Journal of Spine Surgery Feb 2021, 8020; DOI: 10.14444/8020
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  • Analysis of 1027 Adverse Events Reports for Interspinous Process Devices From the US Food and Drug Administration Manufacturer and User Facility Device Experience Database
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  • Comparison analysis of safety outcomes and the rate of subsequent spinal procedures between interspinous spacer without decompression versus minimally invasive lumbar decompression
  • Comparison analysis of safety outcomes and the rate of subsequent spinal procedures between interspinous spacer without decompression versus minimally invasive lumbar decompression
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  • laminectomy
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