Targeted Therapy for Low Back Pain in Elderly Degenerative Lumbar Scoliosis

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Yamada, K. (author)

Targeted Therapy for Low Back Pain in Elderly Degenerative Lumbar Scoliosis

Article/chapterEnglish2016

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Ovid Technologies (Wolters Kluwer Health),2016

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LIBRIS-ID:oai:gup.ub.gu.se/237440
https://gup.ub.gu.se/publication/237440URI
https://doi.org/10.1097/brs.0000000000001524DOI

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Language:English

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Subject category:art swepub-publicationtype

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Study Design. Prospective cohort study. Objective. To compare the novel treatment procedure with nonoperative treatment for low back pain (LBP) in elderly patients with degenerative lumbar scoliosis (DLS). Summary of Background Data. Treatment of LBP associated with elderly DLS is controversial. We developed a novel treatment procedure, termed percutaneous intervertebral-vacuum polymethylmethacrylate injection (PIPI). Methods. We included patients with de novo DLS aged >= 65 years who had LBP with a visual analogue scale (VAS) score of >50 for >= 6 months with intervertebral vacuum and vertebral bone marrow edema (BME) defined on fat-saturated T2-weighted or gadolinium-enhanced T1-weighted magnetic resonance imaging. The primary outcomes were evaluated using the VAS score and modified Oswestry Disability Index (ODI). As an objective measurement, we scored BME on magnetic resonance imaging. Results. Between August 2004 and July 2011, 109 patients underwent PIPI and 53 received nonoperative treatment. At 1 month, mean improvements in VAS scores were -55.3 (95% CI, -60.5 to -50.1) and -1.9 (CI, -7.7 to 3.8) and mean improvements in ODI were -22.7 (CI, -27.3 to -18.2) and -0.6 (CI, -6.6 to 5.4) for the PIPI and nonoperative groups, respectively. At 2 years, mean improvements in VAS scores were -52.2 (CI, -59.9 to -44.4) and -4.0 (CI, -10.9 to 3.0) and mean improvements in ODI were -20.7 (CI, -27.3 to -14.5) and -1.0 (CI, -7.7 to 5.7) for the PIPI and nonoperative groups, respectively. BME substantially decreased in the PIPI group compared with the nonoperative group (P < 0.001) and correlated with VAS score and ODI improvements (VAS score: r = 0.502, P < 0.001; ODI: r = 0.372, P< 0.001). Conclusion. PIPI improved treatment for LBP, with a sustained clinical benefit for at least 2 years.

Subject headings and genre

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Kirurgi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Surgery hsv//eng
bone marrow edema
degenerative lumbar scoliosis
elderly
intervertebral vacuum
low back pain
clinical-practice guideline
vertebral end-plate
adult idiopathic
scoliosis
fusion surgery
interventional therapies
nonoperative
treatment
intervertebral disc
surgical-treatment
randomized-trials
spinal stenosis
Neurosciences & Neurology
Orthopedics

Added entries (persons, corporate bodies, meetings, titles ...)

Nakamae, T. (author)
Shimbo, T. (author)
Kanazawa, T. (author)
Okuda, T. (author)
Takata, H. (author)
Hashimoto, T. (author)
Hiramatsu, T. (author)
Tanaka, N. (author)
Olmarker, Kjell,1958Gothenburg University,Göteborgs universitet,Institutionen för biomedicin, avdelningen för medicinsk kemi och cellbiologi,Institute of Biomedicine, Department of Medical Biochemistry and Cell Biology(Swepub:gu)xolmkj (author)
Fujimoto, Y. (author)
Göteborgs universitetInstitutionen för biomedicin, avdelningen för medicinsk kemi och cellbiologi (creator_code:org_t)

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In:Spine: Ovid Technologies (Wolters Kluwer Health)41:10, s. 872-8790362-2436

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By the author/editor: Yamada, K.; Nakamae, T.; Shimbo, T.; Kanazawa, T.; Okuda, T.; Takata, H.; show more...; Hashimoto, T.; Hiramatsu, T.; Tanaka, N.; Olmarker, Kjell, ...; Fujimoto, Y.; show less...

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MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Surgery

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By the university: University of Gothenburg

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