The London Spine Unit : most advanced spine centre in London
Published article
CONCLUSION: PIPI is a minimally invasive procedure not only for low back pain but also for radiculopathy in elderly DLS patients. It leads to intervertebral stabilization and indirect decompression of the foramen.
Lumbar Decompression Surgery Expert. Best Spinal Surgeon UK
World Neurosurg. 2022 Jul 1:S1878-8750(22)00910-X. doi: 10.1016/j.wneu.2022.06.125. Online ahead of print.
ABSTRACT
BACKGROUND: Percutaneous intervertebral-vacuum polymethylmethacrylate injection (PIPI) is a minimally invasive procedure for low back pain in elderly patients with degenerative lumbar scoliosis (DLS). DLS patients often suffer from radiculopathy due to foraminal stenosis in addition to low back pain. The purpose of this study was to evaluate the clinical and radiological results of PIPI for foraminal stenosis with radiculopathy in elderly DLS patients.
METHODS: We included patients with de novo DLS aged 65 years or older who underwent PIPI. The presence of an intervertebral vacuum on computed tomography (CT) and bone marrow edema on magnetic resonance imaging (MRI) were required for inclusion. The intersegmental radiological parameters on plain radiographs and CT, and the extent of bone marrow edema on MRI were measured. The clinical outcomes were evaluated using the visual analogue scale (VAS) and Oswestry Disability Index (ODI).
RESULTS: We enrolled 40 patients with DLS who underwent PIPI. There were 16 men and 24 women, and the mean age was 79.0 ± 6.3 years. The mean foraminal height and extent of bone marrow edema revealed a significant increase and reduction, respectively, after PIPI (P < 0.05). VAS for radiculopathy and ODI significantly improved after PIPI (P < 0.01). The minimum clinically important differences in VAS for radiculopathy and ODI at the final follow-up were 73.9% and 63.6%, respectively.
CONCLUSION: PIPI is a minimally invasive procedure not only for low back pain but also for radiculopathy in elderly DLS patients. It leads to intervertebral stabilization and indirect decompression of the foramen.
PMID:35787962 | DOI:10.1016/j.wneu.2022.06.125
The London Spine Unit : most advanced spine centre in London
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