A Morphometric Study of the Lumbar Interspinous Space in 100 Stanford University Medical Center Patients

Objective : With the increased use of interspinous spacers in the treatment of lumbar stenosis, knowledge of the geometry of the interspinous space is important. To prevent dislodgment of an interspinous spacer, the accurate depth and width of the interspinous space needs to be established to facilitate the best intraoperative selection of correct spacer size. Methods : To determine the depth and width of the interspinous space, two methods are available which utilize plain film and magnetic resonance imaging (MRI). Data analysis of the interspinous depth and width was undertaken in 100 patients. Results : The standard deviations were variable, since skin thickness (zone 1) was altered by sex and age. The difference in the zone 1 distance between adjacent interspinous processes varied according to gender (p<0.05), but was not influenced by age [p=0.32 by analysis of variance between groups (ANOVA)]. Zone 2, the supraspinous, and zone 3, the interspinous ligament depths, comprise the operative working area during insertion of an interspinous spacer. There were no differences with regard to gender or age (p>0.05). For zones 6 and 7, the interspinous distances at the narrowest and widest points, respectively, were found to decrease with the aging process, but the decrease was not statistically significant. There were no differences with regard to gender (p>0.05). Conclusion : This study provides additional information on the interspinous space. This statistical data are valuable for use in the design of interspinous spacers.