Percutaneous lumbar interbody fusion and Cortoss cement bone augmentation in osteoporotic patients with anterolisthesis: A technical note

Abstract

To describe the technique of bone augmentation using Cortoss cement, in patients with osteoporosis and spondylolisthesis, eligible to posterior stabilization with rods and screws.In this technical note it is described the treatment of spondylolisthesis, up to grade 2, with associated foraminal stenosis or central stenosis, resistant to medical therapy and physiotherapy, in patients with osteopenic/osteoporotic who needs.Pre-operative MOC-DEXA, X-rays, and MRI have to be performed in order to plan.Post-operative imaging was performed with CT ad X-rays.The outcome was assessed using the VAS score, the Oswestry Disability Index and Neuropatic Pain in 4 Questions (NPSI) at a 1,6 and 12 months follow-up and also includedx-rays and CT-scan with volume rendering reconstruction to evaluate the correct bone fusion and the absence of complications.Operation time was 142 min and mean postoperative time until hospital discharge was 2 days. Postoperative values for VAS scores, ODI and NPSI improved significantly compared to pre-operative data. No postprocedural sequelae were observed.This report shows a feasible and safe full percutaneous alternative procedure and represents a minimally invasive management of spondylolisthesis, up to grade 2, with stenosis of vertebral canal and low back pain resistant to medical therapy, even in patients with osteopenia/osteoporosis.