Laszlo Kiss1,2,3, Peter Pal Varga1, Zsolt Szoverfi1,4, Gabor Jakab1, Peter Endre Eltes1,2,3, Aron Lazary5,6. 1. National Center for Spinal Disorders, Buda Health Center, Királyhágó St. 1-3, Budapest, 1126, Hungary. 2. In Silico Biomechanics Laboratory, National Center for Spinal Disorders, Buda Health Center, Budapest, Hungary. 3. School of PhD Studies, Semmelweis University, Budapest, Hungary. 4. Department of Musculosceletal Oncology, Semmelweis University, Budapest, Hungary. 5. National Center for Spinal Disorders, Buda Health Center, Királyhágó St. 1-3, Budapest, 1126, Hungary. aron.lazary@bhc.hu. 6. Department of Musculosceletal Oncology, Semmelweis University, Budapest, Hungary. aron.lazary@bhc.hu.
Abstract
PURPOSE: Percutaneous cement discoplasty (PCD) is a minimally invasive surgical procedure, that can provide a segmental stabilizing and indirect decompression effect in case of severely degenerated discs characterized by vacuum phenomenon. The objective of this study was to evaluate the effects of PCD on spinopelvic radiological parameters and their associations with the clinical outcome. METHODS: Retrospective analysis of prospectively collected dataset of 28 patients (112 lumbar segments) who underwent single- or multilevel PCD was performed. Spinopelvic, intrasegmental and intersegmental parameters were measured on lumbar X-rays pre-, postoperatively and 6 months after the surgery. Correlations between radiological parameters and clinical outcome data were determined. RESULTS: Sacral slope significantly increased (p < .001), and pelvic tilt (p < .05) was decreased after the PCD procedure. Segmental and total lordosis (p < .05, p < .05) disc and foraminal height showed significantly increase (p < .001, p < .001) after procedure. Pain and disability (ODI) significantly decreased due to PCD. An association was found between postoperative increase in SS and improvement in ODI (r = 0.39, p < .05). The change in low back pain was correlated with segmental scoliosis correction (p < .001). Moderate correlation was detected between the increase in disc height and ODI (p < .05) as well as leg pain (p < .01). CONCLUSION: PCD is an effective minimally invasive technique to treat axial pain and disability related to severe lumbar disc degeneration. Our study shows that an improvement in lumbar alignment and a significant indirect foraminal decompression could be achieved with the procedure. These changes can significantly contribute to the pain relief and increase in the patients' functional capacity. These slides can be retrieved under Electronic Supplementary Material.
PURPOSE: Percutaneous cement discoplasty (PCD) is a minimally invasive surgical procedure, that can provide a segmental stabilizing and indirect decompression effect in case of severely degenerated discs characterized by vacuum phenomenon. The objective of this study was to evaluate the effects of PCD on spinopelvic radiological parameters and their associations with the clinical outcome. METHODS: Retrospective analysis of prospectively collected dataset of 28 patients (112 lumbar segments) who underwent single- or multilevel PCD was performed. Spinopelvic, intrasegmental and intersegmental parameters were measured on lumbar X-rays pre-, postoperatively and 6 months after the surgery. Correlations between radiological parameters and clinical outcome data were determined. RESULTS: Sacral slope significantly increased (p < .001), and pelvic tilt (p < .05) was decreased after the PCD procedure. Segmental and total lordosis (p < .05, p < .05) disc and foraminal height showed significantly increase (p < .001, p < .001) after procedure. Pain and disability (ODI) significantly decreased due to PCD. An association was found between postoperative increase in SS and improvement in ODI (r = 0.39, p < .05). The change in low back pain was correlated with segmental scoliosis correction (p < .001). Moderate correlation was detected between the increase in disc height and ODI (p < .05) as well as leg pain (p < .01). CONCLUSION:PCD is an effective minimally invasive technique to treat axial pain and disability related to severe lumbar disc degeneration. Our study shows that an improvement in lumbar alignment and a significant indirect foraminal decompression could be achieved with the procedure. These changes can significantly contribute to the pain relief and increase in the patients' functional capacity. These slides can be retrieved under Electronic Supplementary Material.
Authors: Patricia Dolan; Jin Luo; Phillip Pollintine; Priyan R Landham; Manos Stefanakis; Michael A Adams Journal: Spine (Phila Pa 1976) Date: 2013-08-01 Impact factor: 3.468
Authors: Raymond W J G Ostelo; Rick A Deyo; P Stratford; Gordon Waddell; Peter Croft; Michael Von Korff; Lex M Bouter; Henrica C de Vet Journal: Spine (Phila Pa 1976) Date: 2008-01-01 Impact factor: 3.468
Authors: Antonio E Castellvi; Thomas W Nienke; German A Marulanda; Ryan D Murtagh; Brandon G Santoni Journal: Clin Orthop Relat Res Date: 2014-06 Impact factor: 4.176
Authors: Peter Endre Eltes; Laszlo Kiss; Ferenc Bereczki; Zsolt Szoverfi; Chloé Techens; Gabor Jakab; Benjamin Hajnal; Peter Pal Varga; Aron Lazary Journal: J Orthop Translat Date: 2021-04-01 Impact factor: 5.191
Authors: Gaston Oscar Camino Willhuber; Mariana Bendersky; Carolina Vilte; Gonzalo Kido; Matias Pereira Duarte; Martin Estefan; Julio Bassani; Matias Petracchi; Marcelo Gruenberg; Carlos Sola Journal: Rev Fac Cien Med Univ Nac Cordoba Date: 2021-08-23
Authors: Gaston Camino Willhuber; Mariana Bendersky; Franco L De Cicco; Gonzalo Kido; Matias Pereira Duarte; Martin Estefan; Matias Petracchi; Marcelo Gruenberg; Carlos Sola Journal: Global Spine J Date: 2020-03-13