This is for our readers that treat pain patients
DG Journal Club
BACKGROUND To report clinical results after percutaneous cement discoplasty (PCD) in a multicentric case series with a minimum of two years follow up.
METHODS Between December 2014 and January 2019, 180 patients with low back pain and advanced degeneration were treated with percutaneous discoplasty in two centers.
INCLUSION CRITERIA WERE 65 year or older, mechanical low back pain with or without spinal stenosis that did not respond to conservative management. Patients were divided into three 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 analysis were performed as well as complication and readmission rates.
RESULTS 156 patients, 74% female, mean age 75.8 ± 5.7, mean BMI 29.9 ± 5.2 were included in our study. Overall preoperative Visual Analogue Score (VAS) and Oswestri Disability Index (ODI) were 7.8 ± 0.9 and 68.1 ± 9.6, respectively. At 2 years follow up, mean VAS improvement was 3.56 (CI 95% 3.92 -3.20; p<0.0001) and mean ODI improvement was 17.18 (CI 95 % 19.52 to 14.85; p<0.0001) showing a significant and sustained improvement in both scores. Additionally, 84% of patients reached both VAS and ODI minimum important clinical difference at final follow-up. Finally, 5.7% of patients suffered major complications 30 days postoperatively.
CONCLUSIONS Percutaneous cement discoplasty showed significant improvement of VAS and ODI scores at two years follow-up with relatively low rate of complications.