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Journal of Neurology and Neurorehabilitation Research | Volume 3
allied
academies
November 26-27, 2018 | Dubai, UAE
Spine and Spine Disorders
Addiction Research and Therapy
3rd International Conference on
International Conference on
Joint Event
&
I
ntroduction:
“Motion Preservation” it is not a name or a fashion, but when
indicated, is a philosophy like “Minimally Invasive Surgery” or
“Endoscopic Surgery” etc. To preserve the movement in the
lumbar DDD surgery in the past 15 years have been used, often
by chance, an unbelievable number of interspinous devices
placed on the market. But the literature clearly shows us how
with age the spinous processes undergo radical changes in
their morphology (J.R. Jinkins 2001 and C. Aylott 2012); with
the time from the implantation was also clearly highlighted a
bone remodeling with loss of correction (R. Sobottke 2009), just
to spinous processes fractures (D.H. Kim 2010). Finally, we can
say that the spinous processes were not created to bear a load
(D.E.T. Shepherd 2011).
The diffusion of the interspinous motion preservation devices is
due to the easy and reversible surgical technique and to a low
number of complications in the early time after the surgery.
Biomechanical studies have also clearly shown that many of
these devices do not retain absolutely the movement, even
though they limit it, even in varying degrees, and are really just
“spacers” (H.J. Wilke 2008). Their capability to assist the disc is
also low, because their location is far from the I.A.R. The reasons
for which preserve the movement are linked to the increasingly
high knowledge of occurrence of a high percentage of cases of
ASD after fusion surgery (P. Ekman 2009, K.J. Song 2011). For all
these reasons many firms have shifted their focus on systems
for “interspinous fusion” or other surgeons, like us, on motion
preservation systems no more interspinous but “interlaminar”.
We have therefore developed and diffused a new device for
the treatment of degenerative disk disease of the lumbar
spine which is called IntraSPINE®. The fundamental features
of IntraSPINE® is the difference in compression ratio between
the anterior and posterior parts of the device. The anterior part
(the nose really interlaminar), is able to distract and to re-open
the neuroforamen, which in turn re-lifts and re-aligns the facet
joints, as well as re-strain the thickened yellow ligament due
to the reduction of the disc height. The posterior part which is
compressiblebecause “tunnelized”, does not refrain the spinous
process movement and therefore the ROM (Range of Motion).
The indications are:
• Chronic low back pain in black disk with facet-syndrome
(pre-operative evaluation with dynamic X-rays and block
tests of the facet joints)
• Soft and/or dynamic and foraminal stenosis
• After operations for big expelled disc hernias in young
patients so as to prevent the collapse of the disc and the
subsequent CLBP
• Insufficiency of the supra-spinal fibrous complex
• Topping of after operation for synovial cyst
• Kissing spine
Conclusion:
We present the pictures of various cases treated
with minimum follow-up of 4 years. The absence of major
complications, the minimally invasive surgical procedure and
the good clinical results allow us to say that with a correct
patient selection we can have a “new arrow in our bow” for the
treatment of the lumbar DDD.
Speaker Biography
Giancarlo Guizzardi is staff at Neurosurgical Department of the University and City
Hospital of Florence (Chief of the Spine Surgery Section to December 2015) since
September the 1st 1977. He is Specialist in Neurosurgery, Neurophisiopathology and
Sport’s Medicine. From the beginning of 80’s he devoted his surgical activity especially
to the surgical procedures of the degenerative, traumatic and neoplastyc pathology of
the spine (about 7000 procedures). He published about 90 papers and chapters in the
most important Italian and international medical journals and books. He was invited
as speaker, chairman and organizer to the most prestigious Italian and international
meetings of spinal surgery. He invented and developed new devices, protocols and
min-invasive approaches in “non-fusion” technologies in Degenerative Disk Disease of
the Spine. Since 2002 he is agreement professor of the School of Medicine and Surgery
at Florence University. He is in the editorial board of the “European Spine Journal”,
member of the editorial board of “Journal of Neurosurgical Sciences”, of “World
Neurosurgery”, of “Asian Spine Journal”, of the “World Spine Column Journal” and of
the “Journal of Spinal Surgery”. He is also corresponding member of the Society of
South America Neurosurgical Societies, Honorary lifetime member of the Neuro Spinal
Surgeons Association of India, active member of the EANS (European Association
Neurosurgical Society), SINch (Italian Neurosurgical Society), GIS (Italia Spine Society),
Eurospine (European Spine Society) and NASS (North American Spine Society). From
December 1st, 2015 moved the surgical activity from Florence to the “Tuscany Surgical
Hospital” in Arezzo where is the Head of the Spine Surgery Activity. From December
2016 “Guest Professor” by the first Affiliated Hospital of Zhejiang Chinese Medical
University.
e:
euydgu@tin.itGiancarlo Guizzardi
Tuscany Surgical Center, Italy
Ten years results with Interlaminar Disc Assistance implant “IntraSPINE®”