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More experience in Lumbosacral Liposuction in the treatment of low back pain. 2008

Interventional Spine

Jacques G Theron, MD,
Leopoldo Guimaraens, MD, Non ASSR Member
Alfredo Casasco, MD, Non ASSR Member
Hugo Cuellar, MD, Non ASSR Member
Teresa Sola, MD, Non ASSR Member

Scientific Paper

Purpose

We propose a new therapeutic approach to low back pain consisting in a liposuction (1) of the fat surrounding the atrophied lumbosacral paraspinal muscles. This study was originally based upon the observation that paraspinal muscular atrophy with fat deposits occurs near the region of intervertebral disk hernias (2). Our hypothesis was that reduction in the volume of the fat deposits would allow an expansion of the atrophied muscles and consequently improve the active contention of the lumbo-sacral spine

Methods & Materials

Early results of the technique have been published (3). We present our current experience on 84 patients. All the patients have been treated manually under local anesthesia or light sedation, most of them on an outpatient basis. In all cases the symptoms had persisted for over one year. There were 69% females, mean age 59, lumbar pain 50%, lumbo-radicular pain 34%, diffuse pain of the lower extremities 11%, coccyx pain 5%. Percutaneous intradiscal treatment had been performed previously (6 months to 13 years before liposuction) on 58 patients without meaningful recurrence of disk hernia. In 2 cases the liposuction was performed along with an intradiscal percutaneous treatment.

Results

There has been no complication. Overall results showed 77.3% of very good (14.3%) or good results (63%). One will note the good results obtained on patients with degenerative anterolysthesis (87% very good or good) and on the patients who have had a previous intradiscal therapy (79.3% very good or good). The MR follow-up controls regularly showed an expansion of the paraspinal muscles (fig 1,2,3,4).

Conclusion

It is, at our knowledge, the first time that liposuction is used to encourage muscular expansion. This pilot study has demonstrated safety and therapeutic efficiency. Its indications are not completely determined but it represents a promising therapeutic tool that could be applied to many types of spinal pathology, in association with percutaneous intradiscal therapies, muscular stimulation or physiotherapy.

References

1) Flinn T, Colerman W et al :"History of liposuction" Dermatologic Surgery 26,6,515,2000.

2) McLoughlin RF, D'Arcy EM et al : "The significance of fat and muscle areas in the lumbar paraspinal space : a CT study" J Comput Assist Tomogr 18(2)/275-278,1994.

3) Theron J, Guimaraens et al :"Lumbosacral Liposuction. A new tool for the treatment of low back pain ยป Interventional Neuroradiology 13:153-160,2007.

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