Spine Surgery Research Update: Lumbar Spine Treatment

Spine

Employing the discography procedure in order to determine the source of a patient's pain may accelerate disc degeneration, according to a recent study detailed in an article from The Journal of Bone and Joint Surgery.

The full journal article provides research updates on the latest techniques for lumbar spine treatment as well as discusses other recent research and trends for several types of lumbar spine surgery procedures. The article is summarized below.

Lumbar disc degeneration
Lumbar discography is performed to identify the pain generator, determining whether the disc is causing the patient's pain. In a study on this procedure, 75 patients without serious back pain underwent MRI and discography over a 10-year period. A control group underwent MRI but not discography. Researchers found that patients in the discography group were more likely to experience progression of disc degeneration, more disc herniations and greater loss of height. The researchers concluded that there is a potential for the discography procedure to accelerate disc degeneration.

A separate study evaluated surgery rate in patients who have undergone discography procedures. In this study, 201 consecutive disc degeneration patients underwent discography. Researchers found that 36 percent of the patients had recommendations against surgery based primarily on nonconcordant pain profile and three or more levels of concordant pain during the procedure. Researchers concluded discography could be useful in identifying patients unsuited for surgery.

Researchers evaluated the effects of patients with greater body mass on lumbar disc degeneration. In the study, 44 pairs of healthy male twins were examined. Researchers found that higher body weight was associated with 6.2 percent higher bone density in the spine. Additionally, fewer disc signal irregularities were found in the heavier twins.

Vertebral Compression Fractures

A clinical study was performed on patients with one to three nontraumatic vertebral compression fractures due to osteoporosis or cancer in order to gauge the effectiveness of balloon kyphoplasty. Three hundred patients underwent either the balloon kyphoplasty or nonoperative management treatment for their compression fractures. Researchers followed the patients for two years and concluded that those who underwent the balloon kyphoplasty had a more improved quality of life and more reduced back pain than the patients who underwent the nonoperative management treatment.

Researchers in another study examined the risks of pulmonary cement embolism after multilevel vertebroplasty. Nearly 150 patients were treated with multilevel vertebroplasty had postoperative chest radiographs as assessment for cement embolism. After a two-year follow-up, the researchers confirmed cement embolism in 11 patients who received treatment on all four levels on the same day. No cement embolism was apparent in patients who received treatment for different levels on different days.

Lumbar Disc Herniation
The Spine Patient Outcomes Research Trial analyzed the correlation between the duration of symptoms and results of treatment for lumbar disc herniations. In the study of 927 patients with symptoms for six months or less and 265 patients who had experienced symptoms for more than six months, researchers found that the patients in the latter group were more likely to feel depressed and less likely to believe their symptoms were improving. Additionally, this group was more likely to prefer surgery. Researchers concluded that increased symptom duration due to lumbar disc herniation is related to worse operative and nonoperative treatment outcomes.

Findings in several other studies support a heritable predisposition to lumbar disc herniation.

Read the full article from The Journal of Bone and Joint Surgery on lumbar spine treatment.

Read other coverage on spine surgery treatment methods:

- Spine Surgery Research Update: Biologics in Spine Surgery

- First Patient Treated in Benvenue Medical's KAST Study for Kiva Vertebral Augmentation System


- Orthopedic and Spine Industry Leader to Know: Dr. Mark Flood of Celling Treatment Centers

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