Abstract:
STUDY DESIGN:Prospective experimental uncontrolled trial. BACKGROUND:Lumbar microinstability (MI) is a common cause of lower back pain (LBP) and is related to intervertebral disc degeneration that leads to inability to adequately absorb applied loads. The term "microinstability" has recently been introduced to denote a specific syndrome of biomechanical dysfunction with minimal anatomical change. Trans-facet fixation (TFF) is a minimally invasive technique that involves the placement of screws across the facet joint and into the pedicle, to attain improved stability in the spine. PURPOSE:In this study, we aimed to evaluate the effectiveness, in terms of pain and disability reduction, of a stand-alone TFF in treatment of patients with chronic low back pain (LBP) due to MI. Moreover, as a secondary endpoint, the purpose was to assess the feasibility and safety of a novel percutaneous CT-guided technique. METHODS:We performed percutaneous CT-guided TFF in 84 consecutive patients presenting with chronic LBP attributable to MI at a single lumbar level without spondylolysis. Pre- and post-procedure pain and disability levels were measured using the visual analogue scale (VAS) and Oswestry Disability Index (ODI). RESULTS:At 2 years, TFF resulted in significant reductions in both VAS and ODI scores. CT-guided procedures were tolerated well by all patients under light sedation with a mean procedural time of 45 min, and there were no reported immediate or delayed procedural complications. CONCLUSION:TFF seems to be a powerful technique for lumbar spine stabilization in patients with chronic mechanical LBP related to lumbar MI. CT-guided technique is fast, precise, and safe and can be performed in simple analgo-sedation.
journal_name
Neuroradiologyjournal_title
Neuroradiologyauthors
Manfrè L,De Vivo AE,Al Qatami H,Ventura F,Zobel B,Midiri M,Chandra RV,Carter NS,Hirsch Jdoi
10.1007/s00234-020-02438-4subject
Has Abstractpub_date
2020-09-01 00:00:00pages
1133-1140issue
9eissn
0028-3940issn
1432-1920pii
10.1007/s00234-020-02438-4journal_volume
62pub_type
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