The role of sacrolumbar fat grafting in the treatment of spinal fusion instrumentation-related chronic low back pain: a preliminary report.

Abstract

A report of 2 cases. The purpose of this article is to report 2 preliminary cases with instrumentation-related chronic low back pain (CLBP) successfully treated with fat graft in the sacrolumbar region. Patients undergoing successful spinal fusion surgery may experience new or recurrent CLBP. Instrumentation-related soft-tissue irritation is a well-known etiology of this frustrating condition. Treatment options vary from conservative treatment till instrumentation removal, with no consensus on their efficacy. A 32-year-old patient and a 37-year-old patient with instrumentation-related debilitating CLBP visual analogue scale score 7 and 10, respectively, underwent 1 session of fat grafting in the sacrolumbar region. At 9-month and 6-month follow-ups, both patients reported a substantial pain relief, a considerable improvement in daily quality of life and satisfaction for less implant palpability and visibility. The encouraging results of these preliminary cases may open new horizons for a multidisciplinary approach in treating instrumentation-related CLBP. Fat grafting may represent a valid and minimal invasive option to be taken into account when established therapeutic options fail. Further experience with longer follow-up is needed to confirm our findings. 5.