Fig. 11

Dynamic stabilization system with interspinous spacer for intermittent neurogenic claudication. Lateral radiograph demonstrates the U-shaped device (arrow) placed into the interspinous space at the symptomatic level (L4-5). To maintain stability, the vertical keels are crimped onto the spinous processes (thin arrow). This procedure requires resection of both interspinous and supraspinous ligaments. A common complication in such procedures is spinous process resorption along the implant close to the fixation site. There are other devices available for the same proposal with less invasive approaches