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经皮水泥椎间盘成形术治疗晚期椎间盘退变疾病:病例系列分析

Percutaneous Cement Discoplasty for the Treatment of Advanced Degenerative Disc Conditions: A Case Series Analysis.

作者信息

Camino Willhuber Gaston, Kido Gonzalo, Pereira Duarte Matias, Estefan Martin, Bendersky Mariana, Bassani Julio, Petracchi Matias, Gruenberg Marcelo, Sola Carlos

机构信息

Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.

出版信息

Global Spine J. 2020 Sep;10(6):729-734. doi: 10.1177/2192568219873885. Epub 2019 Sep 6.

Abstract

STUDY DESIGN

Retrospective analysis. Level of evidence III.

OBJECTIVES

To describe the results after a minimum 1-year follow-up in patients treated with percutaneous discoplasty (PD), a minimally invasive technique to treat low back pain in elderly patients with advanced degenerative disc disease. The procedure consists in improving stability by injecting bone cement in a severely degenerated pneumodisc. There are few reports in the literature about this technique.

METHODS

Fifty-four patients with advanced disc disease with/without degenerative scoliosis treated with PD with at least 1 year follow-up were studied, variables included clinical (visual analogue scale [VAS] and Owestry Disability Index [ODI]) and radiological parameters (lumbar lordosis and Cobb angle), as well as hospital length of stay and complications.

RESULTS

At 1-year postoperation, significant pain reduction (VAS: preoperative 7.8 ± 0.90; postoperative 4.4 ± 2.18) and improvement in the ODI (preoperative 62 ± 7.12; postoperative 36.2 ± 15.47) were observed with partial correction of radiological parameters (5° mean increase in lumbar lordosis and decrease in Cobb angle). Mean surgical time was 38 minutes, and the mean length of hospital stay was 1.2 days.

CONCLUSION

PD, currently not a very well-known technique, appears to be-at least in the short-term follow-up-an effective treatment option in selected cases with low back pain due to advanced degenerative disc disease.

摘要

研究设计

回顾性分析。证据等级III。

目的

描述经皮椎间盘成形术(PD)治疗的患者至少随访1年后的结果,经皮椎间盘成形术是一种治疗晚期退行性椎间盘疾病老年患者腰痛的微创技术。该手术通过向严重退变的含气椎间盘内注入骨水泥来提高稳定性。关于该技术的文献报道较少。

方法

研究了54例接受PD治疗的晚期椎间盘疾病伴/不伴退行性脊柱侧凸且至少随访1年的患者,变量包括临床指标(视觉模拟评分法[VAS]和Oswestry功能障碍指数[ODI])和放射学参数(腰椎前凸和Cobb角),以及住院时间和并发症。

结果

术后1年,观察到疼痛显著减轻(VAS:术前7.8±0.90;术后4.4±2.18),ODI改善(术前62±7.12;术后36.2±15.47),放射学参数部分得到矫正(腰椎前凸平均增加5°,Cobb角减小)。平均手术时间为38分钟,平均住院时间为1.2天。

结论

经皮椎间盘成形术目前不是一种广为人知的技术,至少在短期随访中,它似乎是晚期退行性椎间盘疾病所致腰痛特定病例的一种有效治疗选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8684/7383797/ad16148a07cb/10.1177_2192568219873885-fig1.jpg

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