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Efficacy of percutaneous dynamic screws in the treatment of low back pain due to high-grade disc degeneration 2011

Interventional Spine

STEFANO, MARCIA, MD
STEFANO, MARINI, MD, Non ASSR Member
EMANUELE, PIRAS, MD, Non ASSR Member
VALERIA, ERBI, MD, Non ASSR Member
MARIANGELA, MARRAS, MD, Non ASSR Member
GIORGIO, MALLARINI, PROF, Non ASSR Member

Paper/Non-Mentor

Purpose

The aim of this study is to prove the efficacy of totally percutaneous dynamic screws in the treatment of low back pain due to high grade disc degeneration, with involvement of facet joints and narrowing of the spinal canal, especially in L5S1.

Methods & Materials

Twenty patients(fifteen males, five females, average age: 63.1), with low back pain due to black disc L5S1 (Pfirmann grade: 4-5) with severe degeneration of zygapophysial joints and spinal stenosis at the same level were selected for implantation of percutaneous dynamic screws. Diagnosis was confirmed by conventional X-Ray, CTms and MRI. Each procedure was performed using a Percudyn system (Interventional Spine Inc., U.S.). All devices were implanted under fluoroscopic guidance and with local anaesthesia. Clinical evaluation, assessment of pain by mean of a 11-points visual analogue scale (VAS, 0-10) and of function by means of the Oswestry disability scale(ODI 0-100%) was performed at baseline and at one month after the procedure. CTms checks has been performed before and after the procedure and at one month. We also evaluated the areas of both neuroforamens and of the spinal canal before and after the implantation.

Results

A total of 20 intervertebral spaces(19 L5S1, 1 L4L5) were treated in the 20 patients enrolled in the study. Baseline pain was 8.8 ± 1.3, baseline ODI was 64.6 ± 17.3%. At one month, pain was 5.4 ± 2.2, while ODI was 47.7 ± 20.0%(p<0.01). We reported an increase of 14.8% e 16.9% in the areas of the foramens(Av. Area Dx before: 0.97, after: 1.12mm3, Av. Area Sn before: 1.03, after: 1.2mm3) and an increase of 13.0% in spinal canal dimension(Av. Axial area before: 2.09, after: 2.36). Only 35% of patients were still on analgesic drugs at one month follow up(compared with 80% before treatment). No intraprocedural side effects.

Conclusion

From our preliminary data, implant of percutaneous dynamic screws is an effective and safe procedure in reducing low back pain in patients with severe disc degeneration.

References/Financial Disclosures

Consultant of Interventional Spine Inc., U.S.

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