Spinous Process Fixation Systems

8 Spinous Process Fixation Systems

Jordan A. Guntin, Benjamin Khechen, Brittany E. Haws, Kaitlyn L. Cardinal, and Kern Singh

8.1 Introduction

Spinous process fixation is another method utilized to provide spinal stability following interbody fusion. These devices are designed to provide additional stability through interspinous fusion.1 Many interspinous fixation devices (IFDs) also provide interspinous process spacing, which can provide further decompression.1 Additionally, the placement of this device only requires a single midline incision, which may make it a more expedient procedure compared to standard pedicle screw fixation. Surgical indications are presented in ▶ Table 8.1.

8.1.1 Interspinous Fixation Device Components

IFDs contain plates that clamp to the lateral aspects of adjacent spinous processes (▶ Fig. 8.1).2 The clamps are often fixed to the spinous processes through the use of rivets or spiked plates. By securing segment motion posteriorly, an IFD can provide rigidity to the two adjacent vertebrae to which it is secured.2 IFDs can be composed of a variety of materials, including polyetheretherketone (PEEK) and titanium.

Table 8.1 Surgical indications for interspinous fixation devices


Posterior approach spinal fusion

Thoracic procedures

Lumbosacral procedures

Degenerative disk disease


Spinal fracture/dislocation

Spinal tumor

8.1.2 Outcomes

Spinous process fixation has exhibited promising outcomes with regard to its efficacy. Previous studies have demonstrated similar fusion rates when utilizing either supplemental spinous process fixation or pedicle screw fixation.1,3,4 Additionally, IFDs have exhibited comparable rigidity to pedicle screws, especially in flexion–extension movements of the lumbar spine.5,6 This is supplemented with evidence of reduced motion at adjacent segments, suggesting a reduced risk for adjacent segment disease when IFDs are utilized.1 However, the literature is limited regarding high-quality comparative studies. Few studies have examined the complication profile of IFDs.1 Furthermore, evidence regarding long-term outcomes and benefits of IFDs has not been addressed.1 As such, the literature is inadequate to identify the true advantages of IFDs over other methods of fixation.

8.2 Spinous Process Fixation Systems

Table 8.2 Alphatec Spine BridgePoint® Spinous Process Fixation System


Device type



Titanium alloy


Angulating and telescoping plates enhance device fit and promote fusion


Modular aspects and variations


Small: 35–40 mm Medium: 40–45 mm Large: 45–50 mm




Telescoping plates provide up to 5 mm adjustment



MIS TLIF, MIS posterior decompression

Radiographs unavailable

Supplemental fixation system

Alphatec Spine Illico® Posterior Stabilization System

May 14, 2023 | Posted by in Uncategorized | Comments Off on Spinous Process Fixation Systems

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