Degenerative lumbar spinal stenosis with neurogenic intermittent claudication and treatment with the Aperius PercLID System: a preliminary report

Neurosurg Focus. 2010 Jun;28(6):E3. doi: 10.3171/2010.3.FOCUS1034.

Abstract

Object: The aim of this study was to evaluate whether clinical improvement is noticeable after a minimally invasive procedure such as that used with the Aperius PercLID System in patients with degenerative lumbar spinal stenosis (DLSS) and neurogenic intermittent claudication (NIC).

Methods: The patients were treated with the aforementioned system at 3 different centers. The initial requirement to be included in the study was a minimum follow-up of 12 months. The authors studied 40 cases of DLSS in patients with NIC (age 72.7 +/- 8.08 years). Symptom severity, physical function, quality of life, and self-rated pain were assessed preoperatively and at the 12-month follow-up using the Zurich Claudication Questionnaire (ZCQ) and a visual analog scale. The procedure was conducted under spinal (35 patients) or local (5 patients) anesthesia, using biplanar fluoroscopy for visualization.

Results: Single-level treatment was performed in 28 patients and 2-level treatment was performed in 12 patients. Based on time recordings in 24 cases, the mean procedural time was 19.9 +/- 5.0 minutes. The mean pain visual analog scale score improved significantly from 8.1 +/- 2.19 at baseline to 3.44 +/- 2.89 at the 1-year follow-up. The ZCQ score for patient satisfaction showed 90% of the patients being satisfied with the procedure. The mean rates of improvement in ZCQ score for symptom severity and physical function at 1 year were 38.7 +/- 33.3% and 33.8 +/- 29.7%, respectively, and both proved to be statistically significant. Most improvement was seen in mobility, pain/discomfort, and ability for self-care.

Conclusions: In this preliminary study, the Aperius system provided clinically significant improvement after 1 year of follow-up in patients older than 65 years with DLSS and NIC.

Publication types

  • Evaluation Study
  • Multicenter Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Female
  • Humans
  • Intermittent Claudication / etiology
  • Intermittent Claudication / pathology
  • Intermittent Claudication / surgery*
  • Low Back Pain / etiology
  • Low Back Pain / pathology
  • Low Back Pain / surgery
  • Lumbar Vertebrae / diagnostic imaging
  • Lumbar Vertebrae / pathology
  • Lumbar Vertebrae / surgery*
  • Male
  • Middle Aged
  • Minimally Invasive Surgical Procedures / instrumentation
  • Minimally Invasive Surgical Procedures / methods
  • Pilot Projects
  • Prostheses and Implants / standards
  • Prostheses and Implants / statistics & numerical data
  • Prostheses and Implants / trends
  • Prosthesis Implantation / instrumentation
  • Prosthesis Implantation / methods*
  • Radiculopathy / etiology
  • Radiculopathy / pathology
  • Radiculopathy / surgery
  • Radiography
  • Spinal Stenosis / complications
  • Spinal Stenosis / pathology
  • Spinal Stenosis / surgery*
  • Spondylosis / complications
  • Spondylosis / pathology
  • Spondylosis / surgery*
  • Surgical Instruments / standards
  • Surgical Instruments / statistics & numerical data*
  • Surgical Instruments / trends