A group of clinical researchers from Perth and Germany have discovered that a technique commonly used in surgery on the brain is an excellent tool for determining if, and to which extent, surgery is needed for patients with lower back problems.
The international researcher group found that measurement of pressure in the spinal canal improved the diagnostic accuracy compared to using Magnetic Resonance Imaging (MRI) and clinical examination alone.
“As we get older, degeneration causes changes to the spine which in turn causes the spinal canal to become narrower,” Associate Professor Markus Melloh from the Harry Perkins Institute of Medical Research and the University of Western Australia explained.
“However, not everyone with a narrowing of the spinal canal gets a condition known as lumbar spinal stenosis which means some elderly people experience symptoms such as pain, numbness, weakness or radiating leg pain while walking or during prolonged standing. These symptoms can have a significant impact on everyday activities such as housework or shopping as well as on the ability to work.”
“Presently, the routine treatment of spinal stenosis is decompression surgery. However, until now, even experienced surgeons had no way to find out to what extent and how many segments of the spine need to be treated through surgery,” said Dr Thomas Barz, Chief Surgeon of the Asklepios Hospital Uckermark, Germany.
In their study, the researchers inserted a catheter with a pressure sensor into the spinal canal and measured the spinal fluid pressure in patients with spinal stenosis as well as in a control group while both were having surgery. The new method has already been filed for a patent.
“We found that the pressure at the stenosis level in patients with spinal stenosis was three times higher than at unaffected levels in this patient group and compared to the control group, which makes this technique a very promising diagnostic tool for patients with problems of the lumbar spine,” Associate Professor Melloh said.
“It can even be used before surgery by inserting the catheter with the pressure sensor through a needle into the spinal canal. This might help to find out exactly which segments of the spine have been affected and to reduce the amount of time on the operating table, the number of days on sick leave and complications, which benefits both the patients and the taxpayer.”
The scientific report has just been published in a leading orthopaedic journal, the European Spine Journal.