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A 65 year old female with bilateral buttock pain with walking and the radiographs shown in Figure B.
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A 27 year old male with saddle anesthesia and the MRI shown in Figure C.
A 72 year old male that can only walk three hundred yards before he needs to sit down and the MRI in Figure D.
A 72 year old female with a ground level fall who presents with severe back pain and the radiograph and MRI in Figure E.
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Of the options listed, a patient with simple spinal stenosis due to ligamentum hypertropy, without a spondylolithesis would be the best candidate for an X-stop. Kondrashov and associates noted stable good outcomes at 4 years in 14 of 18 patients treated with X-STOP interspinous process decompression as defined as an improvement over preoperative Oswestry scores of 15 points or more. Similar results were seen after 1 year in a European study by Siddiqui and associates. Exclusion and inclusion criteria for these studies varied somewhat, but cauda equina syndrome was the only exclusion criteria listed in both studies. All of the other choices did not represent exclusion criteria in either study.
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