ArticleSurgical neurology international2026
Lumbar stand-alone interspinous fixation without decompression or bone graft: A 14-year cautionary case of late mechanical failure.
Article in Surgical neurology international, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Stand-alone spinous-process fixation devices have been used as a minimally invasive option for selected lumbar degenerative conditions. However, very late implant-bone interface failure is not well documented in the clinical literature. Case Description: A 54-year-old male without osteoporosis underwent stand-alone clamp-type metallic interspinous fixation at the L4/5 level for axial low back pain with stable Grade I degenerative spondylolisthesis. Fourteen years later, he developed severe motion-provoked focal pain at the prior surgical site. Dynamic radiographs demonstrated marked bony erosion/osteolysis at the instrumented level with implant malfunction. Implant removal resulted in substantial symptom relief. Conclusion: This case highlights very late failure of stand-alone clamp-type metallic interspinous fixation device at the L4/5 level. Studies revealed progressive peri-implant osteolysis/erosion with loosening causing mechanical low back pain. The failure of this interspinous device underscores the need for long-term patient surveillance following the placement of a stand-alone interspinous process fixation device.
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