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Indirect foraminal decompression and improvement in the lumbar alignment after percutaneous cement discoplasty

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Abstract

Purpose

Percutaneous cement discoplasty (PCD) is a minimally invasive surgical procedure, that can provide a segmental stabilizing and indirect decompression effect in case of severely degenerated discs characterized by vacuum phenomenon. The objective of this study was to evaluate the effects of PCD on spinopelvic radiological parameters and their associations with the clinical outcome.

Methods

Retrospective analysis of prospectively collected dataset of 28 patients (112 lumbar segments) who underwent single- or multilevel PCD was performed. Spinopelvic, intrasegmental and intersegmental parameters were measured on lumbar X-rays pre-, postoperatively and 6 months after the surgery. Correlations between radiological parameters and clinical outcome data were determined.

Results

Sacral slope significantly increased (p < .001), and pelvic tilt (p < .05) was decreased after the PCD procedure. Segmental and total lordosis (p < .05, p < .05) disc and foraminal height showed significantly increase (p < .001, p < .001) after procedure. Pain and disability (ODI) significantly decreased due to PCD. An association was found between postoperative increase in SS and improvement in ODI (r = 0.39, p < .05). The change in low back pain was correlated with segmental scoliosis correction (p < .001). Moderate correlation was detected between the increase in disc height and ODI (p < .05) as well as leg pain (p < .01).

Conclusion

PCD is an effective minimally invasive technique to treat axial pain and disability related to severe lumbar disc degeneration. Our study shows that an improvement in lumbar alignment and a significant indirect foraminal decompression could be achieved with the procedure. These changes can significantly contribute to the pain relief and increase in the patients’ functional capacity.

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Funding

Aron Lazary has received research grants from the Hungarian Scientific Research Fund, Budapest, Hungary, Award number: OTKA FK123884.

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Author notes

    Authors and Affiliations

    1. National Center for Spinal Disorders, Buda Health Center, Királyhágó St. 1-3, Budapest, 1126, Hungary

      Laszlo Kiss, Peter Pal Varga, Zsolt Szoverfi, Gabor Jakab, Peter Endre Eltes & Aron Lazary

    2. In Silico Biomechanics Laboratory, National Center for Spinal Disorders, Buda Health Center, Budapest, Hungary

      Laszlo Kiss & Peter Endre Eltes

    3. School of PhD Studies, Semmelweis University, Budapest, Hungary

      Laszlo Kiss & Peter Endre Eltes

    4. Department of Musculosceletal Oncology, Semmelweis University, Budapest, Hungary

      Zsolt Szoverfi & Aron Lazary

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    1. Laszlo Kiss
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    4. Gabor Jakab
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    Correspondence to Aron Lazary.

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    Laszlo Kiss and Peter Pal Varga have equally contributed to the research.

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    Kiss, L., Varga, P.P., Szoverfi, Z. et al. Indirect foraminal decompression and improvement in the lumbar alignment after percutaneous cement discoplasty. Eur Spine J 28, 1441–1447 (2019). https://doi.org/10.1007/s00586-019-05966-7

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    • DOI: https://doi.org/10.1007/s00586-019-05966-7

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