Annals of Surgical Innovation and Research | |
Minimally invasive facet restoration implant for chronic lumbar zygapophysial pain: 1-year outcomes | |
Hans-Jörg Meisel3  Konrad Seller2  Achim Lϋth2  Karin Bϋttner-Janz4  Peter Stosberg3  Alexander Moser5  Larry E Miller6  Jon E Block6  Luiz Pimenta1  | |
[1] Instituto de Patologia da Caluna, Rua Vergueiro 1421-Sala 305, Sao Paulo, Brazil | |
[2] Spine Center Freiburg, Hornus Str. 18, Freiburg, D-79108, Germany | |
[3] Center of Neurosciences, Department of Neurosurgery, BG-Clinic Bergmannstrost, Merseburger Strasse 165, Halle, Germany | |
[4] Büttner-Janz Spinefoundation, Meinekestr. 6, Berlin, 10719, Germany | |
[5] Vivantes Klinikum, Landsberger Allee 49, Berlin, 10249, Germany | |
[6] The Jon Block Group, 2210 Jackson Street, Suite 401, San Francisco 94115, CA, USA | |
关键词: Zygapophysial; Spine; Pain; Minimally invasive; Lumbar; Implant; Glyder; Facet; | |
Others : 1083882 DOI : 10.1186/s13022-014-0007-5 |
|
received in 2014-07-02, accepted in 2014-10-08, 发布年份 2014 | |
【 摘 要 】
Background
The zygapophysial (facet) joint is the primary pain generator in one third of chronic low back pain cases. Current treatment options include temporarily palliative nonsurgical approaches, facet injections, radiofrequency denervation, and, rarely, lumbar arthrodesis. The purpose of this study was to assess the safety and effectiveness of a minimally invasive implant intended to restore facet joint function in patients with chronic lumbar facetogenic pain.
Methods
This prospective, multi-center feasibility study enrolled patients with confirmed lumbar facetogenic joint pain at 1 or 2 levels who underwent at least 6 months of unsuccessful nonoperative care. Patients received a minimally invasive implant (Glyder® Facet Restoration Device, Zyga Technology, Inc., Minnetonka, MN) intended to restore facet joint function while preserving the native anatomy. Main outcomes included back pain severity using a visual analogue scale, back-specific disability using the Oswestry Disability Index (ODI), and adverse events adjudicated by an independent Clinical Events Committee.
Results
Of 40 enrolled patients, 37 patients received the facet restoration implant and 34 patients had complete 1-year follow-up data available. Over the 1-year follow-up period, back pain severity decreased 41% and ODI decreased 34%, on average. Freedom from a device- or procedure-related serious adverse event through 1 year was 84%. Implant migration was observed in 3 patients and implant expulsion from the facet joint occurred in 3 patients. In total, 2 (5.4%) patients underwent implant removal through 1 year post-treatment.
Conclusions
A minimally invasive facet restoration implant is a promising treatment option in select patients with chronic lumbar zygapophysial pain who have exhausted nonsurgical treatments, with therapeutic benefit persisting at 1 year follow-up.
【 授权许可】
2014 Meisel et al.; licensee BioMed Central Ltd.
【 预 览 】
Files | Size | Format | View |
---|---|---|---|
20150113113844137.pdf | 2996KB | download | |
Figure 4. | 20KB | Image | download |
Figure 3. | 21KB | Image | download |
Figure 2. | 21KB | Image | download |
Figure 1. | 88KB | Image | download |
【 图 表 】
Figure 1.
Figure 2.
Figure 3.
Figure 4.
【 参考文献 】
- [1]Yang KH, King AI: Mechanism of facet load transmission as a hypothesis for low-back pain. Spine (Phila Pa 1976) 1984, 9:557-565.
- [2]Ozaktay AC, Cavanaugh JM, Blagoev DC, King AI: Phospholipase A2-induced electrophysiologic and histologic changes in rabbit dorsal lumbar spine tissues. Spine (Phila Pa 1976) 1995, 20:2659-2668.
- [3]Ozaktay AC, Cavanaugh JM, Blagoev DC, Getchell TV, King AI: Effects of a carrageenan-induced inflammation in rabbit lumbar facet joint capsule and adjacent tissues. Neurosci Res 1994, 20:355-364.
- [4]Little JS, Khalsa PS: Human lumbar spine creep during cyclic and static flexion: creep rate, biomechanics, and facet joint capsule strain. Ann Biomed Eng 2005, 33:391-401.
- [5]Little JS, Ianuzzi A, Chiu JB, Baitner A, Khalsa PS: Human lumbar facet joint capsule strains: II. Alteration of strains subsequent to anterior interbody fixation. Spine J 2004, 4:153-162.
- [6]Ianuzzi A, Little JS, Chiu JB, Baitner A, Kawchuk G, Khalsa PS: Human lumbar facet joint capsule strains: I. During physiological motions. Spine J 2004, 4:141-152.
- [7]Gotfried Y, Bradford DS, Oegema TR Jr: Facet joint changes after chemonucleolysis-induced disc space narrowing. Spine (Phila Pa 1976) 1986, 11:944-950.
- [8]Panjabi MM, Krag MH, Chung TQ: Effects of disc injury on mechanical behavior of the human spine. Spine (Phila Pa 1976) 1984, 9:707-713.
- [9]Haher TR, O’Brien M, Dryer JW, Nucci R, Zipnick R, Leone DJ: The role of the lumbar facet joints in spinal stability. Identification of alternative paths of loading. Spine (Phila Pa 1976) 1994, 19:2667-2670. discussion 2671
- [10]Adams MA, Freeman BJ, Morrison HP, Nelson IW, Dolan P: Mechanical initiation of intervertebral disc degeneration. Spine (Phila Pa 1976) 2000, 25:1625-1636.
- [11]DePalma MJ, Ketchum JM, Saullo T: What is the source of chronic low back pain and does age play a role? Pain Med 2011, 12:224-233.
- [12]Jackson RP: The facet syndrome. Myth or reality? Clin Orthop Relat Res 1992, 279:110-121.
- [13]Esses SI, Botsford DJ, Kostuik JP: The role of external spinal skeletal fixation in the assessment of low-back disorders. Spine (Phila Pa 1976) 1989, 14:594-601.
- [14]Esses SI, Moro JK: The value of facet joint blocks in patient selection for lumbar fusion. Spine (Phila Pa 1976) 1993, 18:185-190.
- [15]Fujiwara A, Tamai K, An HS, Lim TH, Yoshida H, Kurihashi A, Saotome K: Orientation and osteoarthritis of the lumbar facet joint. Clin Orthop Relat Res 2001, 385:88-94.
- [16]Ostelo RW, Deyo RA, Stratford P, Waddell G, Croft P, Von Korff M, Bouter LM, de Vet HC: Interpreting change scores for pain and functional status in low back pain: towards international consensus regarding minimal important change. Spine (Phila Pa 1976) 2008, 33:90-94.
- [17]Hagg O, Fritzell P, Nordwall A: The clinical importance of changes in outcome scores after treatment for chronic low back pain. Eur Spine J 2003, 12:12-20.
- [18]Fleming TR: Addressing missing data in clinical trials. Ann Intern Med 2011, 154:113-117.
- [19]Carette S, Marcoux S, Truchon R, Grondin C, Gagnon J, Allard Y, Latulippe M: A controlled trial of corticosteroid injections into facet joints for chronic low back pain. N Engl J Med 1991, 325:1002-1007.
- [20]Dolan AL, Ryan PJ, Arden NK, Stratton R, Wedley JR, Hamann W, Fogelman I, Gibson T: The value of SPECT scans in identifying back pain likely to benefit from facet joint injection. Br J Rheumatol 1996, 35:1269-1273.
- [21]Pneumaticos SG, Chatziioannou SN, Hipp JA, Moore WH, Esses SI: Low back pain: prediction of short-term outcome of facet joint injection with bone scintigraphy. Radiology 2006, 238:693-698.
- [22]van Kleef M, Barendse GA, Kessels A, Voets HM, Weber WE, de Lange S: Randomized trial of radiofrequency lumbar facet denervation for chronic low back pain. Spine (Phila Pa 1976) 1999, 24:1937-1942.
- [23]Leclaire R, Fortin L, Lambert R, Bergeron YM, Rossignol M: Radiofrequency facet joint denervation in the treatment of low back pain: a placebo-controlled clinical trial to assess efficacy. Spine (Phila Pa 1976) 2001, 26:1411-1416. discussion 1417
- [24]van Wijk RM, Geurts JW, Wynne HJ, Hammink E, Buskens E, Lousberg R, Knape JT, Groen GJ: Radiofrequency denervation of lumbar facet joints in the treatment of chronic low back pain: a randomized, double-blind, sham lesion-controlled trial. Clin J Pain 2005, 21:335-344.
- [25]Falco FJ, Manchikanti L, Datta S, Sehgal N, Geffert S, Onyewu O, Zhu J, Coubarous S, Hameed M, Ward SP, Sharma M, Hameed H, Singh V, Boswell MV: An update of the effectiveness of therapeutic lumbar facet joint interventions. Pain Physician 2012, 15:E909-E953.
- [26]Van de Kelft E: Lumbar facet resurfacing: first experience with the FENIX implant.J Spinal Disord Tech 2013, PMID 23563335.