title: Degenerative lumbar spinal stenosis with neurogenic intermittent claudication and treatment with the Aperius PercLID System: a preliminary report.
abstract: OBJECTIVE
  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.
authors.affiliation: Department of Neurosurgery, Virgen de la Arrixaca University Hospital, El Palmar, Murcia, Spain. marcelo.galarza@carm.es
authors.forename: Marcelo
authors.initials: M
authors.lastname: Galarza
authors.forename: Anthony P
authors.initials: AP
authors.lastname: Fabrizi
authors.forename: Raffaella
authors.initials: R
authors.lastname: Maina
authors.forename: Roberto
authors.initials: R
authors.lastname: Gazzeri
authors.forename: Juan F
authors.initials: JF
authors.lastname: Martínez-Lage
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007383:Intermittent Claudication / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D017116:Low Back Pain / Q000209:etiology / Q000473:pathology / Q000601:surgery; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation / Q000379:methods; D010865:Pilot Projects; D019736:Prostheses and Implants / Q000592:standards / Q000706:statistics & numerical data / Q000639:trends; D019919:Prosthesis Implantation / Q000295:instrumentation / Q000379:methods*; D011843:Radiculopathy / Q000209:etiology / Q000473:pathology / Q000601:surgery; D011859:Radiography; D013130:Spinal Stenosis / Q000150:complications / Q000473:pathology / Q000601:surgery*; D055009:Spondylosis / Q000150:complications / Q000473:pathology / Q000601:surgery*; D013525:Surgical Instruments / Q000592:standards / Q000706:statistics & numerical data* / Q000639:trends