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30 patients with discoplasty of the lumbar spine

30 patients with discoplasty of the lumbar spine · Patients were asked about how much better or worse they felt in range 0 to 100 MacNab criteria: Excellent •No pain, no movement

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Page 1: 30 patients with discoplasty of the lumbar spine · Patients were asked about how much better or worse they felt in range 0 to 100 MacNab criteria: Excellent •No pain, no movement

30 patients with discoplasty of the lumbar spine

Page 2: 30 patients with discoplasty of the lumbar spine · Patients were asked about how much better or worse they felt in range 0 to 100 MacNab criteria: Excellent •No pain, no movement

Outcome (MacNab): Excellent

Reduction of Disc Size: 63,02%

preoperatively 12 mo post-operatively

Page 3: 30 patients with discoplasty of the lumbar spine · Patients were asked about how much better or worse they felt in range 0 to 100 MacNab criteria: Excellent •No pain, no movement

preoperatively 12 mo post-operatively

Outcome (MacNab): Good

Reduction of Disc Size: 73,39%

Page 4: 30 patients with discoplasty of the lumbar spine · Patients were asked about how much better or worse they felt in range 0 to 100 MacNab criteria: Excellent •No pain, no movement

Outcome (MacNab): Excellent

Reduction of Disc Size: 31,47%

preoperatively 24 mo post-operatively 12 mo post-operatively

Page 5: 30 patients with discoplasty of the lumbar spine · Patients were asked about how much better or worse they felt in range 0 to 100 MacNab criteria: Excellent •No pain, no movement

Outcome (MacNab): Excellent

Reduction of Disc Size: 45,75%

preoperatively 12 mo post-operatively

Page 6: 30 patients with discoplasty of the lumbar spine · Patients were asked about how much better or worse they felt in range 0 to 100 MacNab criteria: Excellent •No pain, no movement

Outcome (MacNab): Excellent

Reduction of Disc Size: 33,83%

preoperatively 12 mo post-operatively 3 mo post-operatively

Page 7: 30 patients with discoplasty of the lumbar spine · Patients were asked about how much better or worse they felt in range 0 to 100 MacNab criteria: Excellent •No pain, no movement

preoperatively 12 mo post-operatively

Outcome (MacNab): Excellent

Reduction of Disc Size: 51,30%

3 mo post-operatively

Page 8: 30 patients with discoplasty of the lumbar spine · Patients were asked about how much better or worse they felt in range 0 to 100 MacNab criteria: Excellent •No pain, no movement

Outcome (MacNab): Excellent

Reduction of Disc Size: 30,19%

preoperatively 12 mo post-operatively

Page 9: 30 patients with discoplasty of the lumbar spine · Patients were asked about how much better or worse they felt in range 0 to 100 MacNab criteria: Excellent •No pain, no movement

Outcome (MacNab): Excellent

Reduction of Disc Size: 16,36%

preoperatively 12 mo post-operatively

Page 10: 30 patients with discoplasty of the lumbar spine · Patients were asked about how much better or worse they felt in range 0 to 100 MacNab criteria: Excellent •No pain, no movement

Outcome (MacNab): Excellent

Reduction of Disc Size: 16,36%

preoperatively 12 mo post-operatively

Page 11: 30 patients with discoplasty of the lumbar spine · Patients were asked about how much better or worse they felt in range 0 to 100 MacNab criteria: Excellent •No pain, no movement

Outcome (MacNab): Excellent

Reduction of Disc Size: 13,42%

preoperatively 12 mo post-operatively 5 mo post-operatively

Page 12: 30 patients with discoplasty of the lumbar spine · Patients were asked about how much better or worse they felt in range 0 to 100 MacNab criteria: Excellent •No pain, no movement

Outcome (MacNab): Good

Reduction of Disc Size: 9,97%

preoperatively 12 mo post-operatively

Page 13: 30 patients with discoplasty of the lumbar spine · Patients were asked about how much better or worse they felt in range 0 to 100 MacNab criteria: Excellent •No pain, no movement

Outcome (MacNab): Excellent

Reduction of Disc Size: 52,78%

preoperatively 12 mo post-operatively

Page 14: 30 patients with discoplasty of the lumbar spine · Patients were asked about how much better or worse they felt in range 0 to 100 MacNab criteria: Excellent •No pain, no movement

Outcome (MacNab): Good

Reduction of Disc Size: 7,13%

preoperatively 12 mo post-operatively

Page 15: 30 patients with discoplasty of the lumbar spine · Patients were asked about how much better or worse they felt in range 0 to 100 MacNab criteria: Excellent •No pain, no movement

Outcome (MacNab): Good

Reduction of Disc Size: 35,98%

preoperatively 12 mo post-operatively

Page 16: 30 patients with discoplasty of the lumbar spine · Patients were asked about how much better or worse they felt in range 0 to 100 MacNab criteria: Excellent •No pain, no movement

Outcome (MacNab): Excellent

Reduction of Disc Size: 41,02%

preoperatively 12 mo post-operatively

Page 17: 30 patients with discoplasty of the lumbar spine · Patients were asked about how much better or worse they felt in range 0 to 100 MacNab criteria: Excellent •No pain, no movement

Outcome (MacNab): Moderate

Reduction of Disc Size: 13,80%

preoperatively 12 mo post-operatively 6 mo post-operatively

Page 18: 30 patients with discoplasty of the lumbar spine · Patients were asked about how much better or worse they felt in range 0 to 100 MacNab criteria: Excellent •No pain, no movement

Outcome (MacNab): Excellent

Reduction of Disc Size: 36,92%

preoperatively 12 mo post-operatively

Page 19: 30 patients with discoplasty of the lumbar spine · Patients were asked about how much better or worse they felt in range 0 to 100 MacNab criteria: Excellent •No pain, no movement

Outcome (MacNab): Good

Reduction of Disc Size: 35,14%

preoperatively 12 mo post-operatively

Page 20: 30 patients with discoplasty of the lumbar spine · Patients were asked about how much better or worse they felt in range 0 to 100 MacNab criteria: Excellent •No pain, no movement

Outcome (MacNab): Good

Reduction of Disc Size: 4,84%

preoperatively 12 mo post-operatively

Page 21: 30 patients with discoplasty of the lumbar spine · Patients were asked about how much better or worse they felt in range 0 to 100 MacNab criteria: Excellent •No pain, no movement

Outcome (MacNab): Good

Reduction of Disc Size: 8,08%

preoperatively 12 mo post-operatively

Page 22: 30 patients with discoplasty of the lumbar spine · Patients were asked about how much better or worse they felt in range 0 to 100 MacNab criteria: Excellent •No pain, no movement

Outcome (MacNab): Excellent

Reduction of Disc Size: 63,04%

preoperatively 12 mo post-operatively

Page 23: 30 patients with discoplasty of the lumbar spine · Patients were asked about how much better or worse they felt in range 0 to 100 MacNab criteria: Excellent •No pain, no movement

Outcome (MacNab): Good

Reduction of Disc Size: 64,87%

preoperatively 12 mo post-operatively

Page 24: 30 patients with discoplasty of the lumbar spine · Patients were asked about how much better or worse they felt in range 0 to 100 MacNab criteria: Excellent •No pain, no movement

Outcome (MacNab): Good

Reduction of Disc Size: 45,91%

preoperatively 12 mo post-operatively

Page 25: 30 patients with discoplasty of the lumbar spine · Patients were asked about how much better or worse they felt in range 0 to 100 MacNab criteria: Excellent •No pain, no movement

Outcome (MacNab): Excellent

Reduction of Disc Size: 6,95%

preoperatively 12 mo post-operatively

Page 26: 30 patients with discoplasty of the lumbar spine · Patients were asked about how much better or worse they felt in range 0 to 100 MacNab criteria: Excellent •No pain, no movement

Outcome (MacNab): Excellent

Reduction of Disc Size: 22,08%

preoperatively 12 mo post-operatively

Page 27: 30 patients with discoplasty of the lumbar spine · Patients were asked about how much better or worse they felt in range 0 to 100 MacNab criteria: Excellent •No pain, no movement

Outcome (MacNab): Excellent

Reduction of Disc Size: 46,78%

preoperatively 12 mo post-operatively

Page 28: 30 patients with discoplasty of the lumbar spine · Patients were asked about how much better or worse they felt in range 0 to 100 MacNab criteria: Excellent •No pain, no movement

Outcome (MacNab): Excellent

Reduction of Disc Size: 69,37%

preoperatively 12 mo post-operatively

Page 29: 30 patients with discoplasty of the lumbar spine · Patients were asked about how much better or worse they felt in range 0 to 100 MacNab criteria: Excellent •No pain, no movement

Outcome (MacNab): Excellent

Reduction of Disc Size: 35,71%

preoperatively 12 mo post-operatively

Page 30: 30 patients with discoplasty of the lumbar spine · Patients were asked about how much better or worse they felt in range 0 to 100 MacNab criteria: Excellent •No pain, no movement

Outcome (MacNab): Excellent

Reduction of Disc Size: 16,32%

preoperatively 12 mo post-operatively

Page 31: 30 patients with discoplasty of the lumbar spine · Patients were asked about how much better or worse they felt in range 0 to 100 MacNab criteria: Excellent •No pain, no movement

Outcome (MacNab): Excellent

Reduction of Disc Size: 42,55%

preoperatively 24 mo post-operatively 12 mo post-operatively

Page 32: 30 patients with discoplasty of the lumbar spine · Patients were asked about how much better or worse they felt in range 0 to 100 MacNab criteria: Excellent •No pain, no movement

Outcome (MacNab): Excellent

Reduction of Disc Size: 41,33%

preoperatively 12 mo post-operatively

Page 33: 30 patients with discoplasty of the lumbar spine · Patients were asked about how much better or worse they felt in range 0 to 100 MacNab criteria: Excellent •No pain, no movement

Outcome (MacNab): Excellent

Reduction of Disc Size: 44,17%

preoperatively 12 mo post-operatively

Page 34: 30 patients with discoplasty of the lumbar spine · Patients were asked about how much better or worse they felt in range 0 to 100 MacNab criteria: Excellent •No pain, no movement
Page 35: 30 patients with discoplasty of the lumbar spine · Patients were asked about how much better or worse they felt in range 0 to 100 MacNab criteria: Excellent •No pain, no movement

Outcome (MacNab): Excellent

preoperatively 3 mo post-operatively

Page 36: 30 patients with discoplasty of the lumbar spine · Patients were asked about how much better or worse they felt in range 0 to 100 MacNab criteria: Excellent •No pain, no movement

Included were patients that had:

• Pre- and post- operative MRI

• Completed Oswestry and VAS questionnaires

• Been operated at least 12 months ago

Page 37: 30 patients with discoplasty of the lumbar spine · Patients were asked about how much better or worse they felt in range 0 to 100 MacNab criteria: Excellent •No pain, no movement

30 patients were included

21 males and 7 females

Mean age was 42,52 years (range: 20 to 69 years)

Page 38: 30 patients with discoplasty of the lumbar spine · Patients were asked about how much better or worse they felt in range 0 to 100 MacNab criteria: Excellent •No pain, no movement
Page 39: 30 patients with discoplasty of the lumbar spine · Patients were asked about how much better or worse they felt in range 0 to 100 MacNab criteria: Excellent •No pain, no movement

0

2

4

6

8

10

12

14

16

18

L1-L2 L2-L3 L3-L4 L4-L5 L5-S1

1 2 4

10

18

S

u

m

o

f

L

e

v

e

l

s

Page 40: 30 patients with discoplasty of the lumbar spine · Patients were asked about how much better or worse they felt in range 0 to 100 MacNab criteria: Excellent •No pain, no movement

0

1

2

3

4

5

VAS-Lumbar VAS-Extreme

4,91 4,23

2,15 1,48

VAS Average

Preoperatively Postoperatively

0

10

20

30

Oswestry

34,53

17,09

Oswestry Average

Difference

VAS-lumbar: -58,18%

VAS-extreme: -65,66%

Oswestry: -49,51%

Page 41: 30 patients with discoplasty of the lumbar spine · Patients were asked about how much better or worse they felt in range 0 to 100 MacNab criteria: Excellent •No pain, no movement

Patients were asked about how much better or worse they felt in range 0 to 100

MacNab criteria:

• No pain, no movement difficulty Excellent

• Occasional pain (but no radicular) Good

• Minor improvement, but with minor daily impairment Fair

• No improvement, operative treatment is necessary Poor

Page 42: 30 patients with discoplasty of the lumbar spine · Patients were asked about how much better or worse they felt in range 0 to 100 MacNab criteria: Excellent •No pain, no movement

Excellent: 18

Good: 7

Fair: 2

Poor: 3

Page 43: 30 patients with discoplasty of the lumbar spine · Patients were asked about how much better or worse they felt in range 0 to 100 MacNab criteria: Excellent •No pain, no movement

In the following pages, pictures of cases with pre- and 12 month post- operative MRIs is presented. Whenever there is an intermediate MRI available, it will be presented separately

On the top right box, MacNab criteria and the percent of the intervertebral disc reduction is presented.

Page 44: 30 patients with discoplasty of the lumbar spine · Patients were asked about how much better or worse they felt in range 0 to 100 MacNab criteria: Excellent •No pain, no movement
Page 45: 30 patients with discoplasty of the lumbar spine · Patients were asked about how much better or worse they felt in range 0 to 100 MacNab criteria: Excellent •No pain, no movement

Editors

• Nikolaos D. Benardos Orthopaedic – Spine Surgeon

• Evangelos M. Rokas Neurosurgeon

Acknowledgements

Current study was performed under the supervision of the

Professor of Orthpaedics and Spine Surgeon

Alexandros Hadjipavlou