Percutaneous Cement Discoplasty for Degenerative Low Back Pain with Vacuum Phenomenon: A Multicentric Study with a Minimum of 2 Years of Follow-Up

World Neurosurg. 2021 Nov:155:e210-e217. doi: 10.1016/j.wneu.2021.08.042. Epub 2021 Aug 14.

Abstract

Background: To report clinical results after percutaneous cement discoplasty (PCD) in a multicentric case series with a minimum of 2 years of follow-up.

Methods: Between December 2014 and January 2019, 180 patients with low back pain and advanced degeneration were treated with percutaneous discoplasty in 2 centers. The inclusion criteria were as follows: patients 65 years or older, with mechanical low back pain with or without spinal stenosis, who did not respond to conservative management. Patients were divided into 3 groups: group 1: patients without previous spine surgeries who underwent PCD, group 2: patients with previous spine surgeries who underwent PCD, and group 3: patients with/without previous surgery who underwent PCD plus decompression surgery. Clinical and radiological analyses were performed as well as complication and readmission rates.

Results: A total of 156 patients (74% female; mean age, 75.8 ± 5.7 years; mean body mass index, 29.9 ± 5.2) were included in our study. Overall preoperative visual analog score (VAS) and Oswestry Disability Index (ODI) were 7.8 ± 0.9 and 68.1 ± 9.6, respectively. At 2 years of follow-up, mean VAS improvement was 3.56 (95% confidence interval: 3.92-3.20; P < 0.0001) and mean ODI improvement was 17.18 (95% confidence interval: 19.52-14.85; P < 0.0001), showing a significant and sustained improvement in both scores. In addition, 84% of patients reached both VAS and ODI minimum important clinical difference at the final follow-up. Finally, 5.7% of patients suffered major complications 30 days postoperatively.

Conclusions: PCD showed significant improvement of VAS and ODI scores at 2 years of follow-up with relatively low rate of complications.

Keywords: Low back pain; Minimally invasive surgery; Percutaneous cement discoplasty.

Publication types

  • Multicenter Study

MeSH terms

  • Aged
  • Cementoplasty / methods*
  • Female
  • Follow-Up Studies
  • Humans
  • Intervertebral Disc Degeneration / complications
  • Intervertebral Disc Degeneration / surgery*
  • Low Back Pain / complications
  • Low Back Pain / surgery*
  • Male
  • Treatment Outcome