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Decompression lumbar

Giancarlo D'Andrea, Giovanni Sessa, Veronica Picotti, Antonino Raco
We report the case of a large lumbar schwannoma eroding the vertebra and originating from spinal canal with invasion of the retroperitoneal space. We also review all the cases in literature reporting lumbar schwannomas eroding the vertebral bodies and invading the retroperitoneal space focusing on the surgical strategies to manage them. Spinal CT-scan revealed a 44 mm × 55 mm inhomogeneous soft-tissue mass arising from the right L5-S1 neural foramen and its most anterior portion had a clear colliquative aspect...
2016: Case Reports in Surgery
Enrico Tessitore, Granit Molliqaj, Karl Schaller, Oliver Pascal Gautschi
Extreme lateral interbody fusion (XLIF) is an alternative to standard posterior approaches for achieving fusion in the lumbar spine. It allows exposure of the lateral aspect of the lumbar disc through a lateral approach with the possibility to insert a wide footprint interbody cage as a stand-alone procedure or associated with a uni- or bilateral percutaneous fixation. This is a retrospective series of 20 consecutive patients operated with a XLIF procedure from 2014 to 2015. N=10 women and N=10 men with a mean age of 67...
October 17, 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Mohamad Bydon, Mohamed Macki, Panagiotis Kerezoudis, Daniel M Sciubba, Jean-Paul Wolinsky, Timothy F Witham, Ziya L Gokaslan, Ali Bydon
INTRODUCTION: The objective of this study is to determine the incidence and prognostic factors of adjacent segment disease (ASD) following first-time lumbar discectomy (LD). METHODS: We retrospectively reviewed all neurosurgical patients who underwent first-time LD for degenerative lumbar disease from 1990 to 2012. ASD was defined as a clinical and radiographic progression of degenerative spinal disease that required surgical decompression (with or without fusion) at the level above or below the index discectomy...
October 17, 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Tsuyoshi Goto, Toshinori Sakai, Tetsuya Enishi, Nori Sato, Koji Komatsu, Koichi Sairyo, Shinsuke Katoh
Neurogenic intermittent claudication is a main symptom in lumbar spinal stenosis (LSS), and postural change is often observed during walking. This study aimed to identify the changes in posture and muscle activity in the trunk and legs during walking in patients with LSS by examining 6 patients who had undergone decompression surgery. None of them had significant paralysis. Gait analysis using Vicon motion capture system(®) with electromyographic recordings of the paravertebral muscles (PVM) and vastus lateralis muscle (VL) was performed preoperatively and 2 weeks postoperatively...
October 6, 2016: Gait & Posture
Shiro Imagama, Noriaki Kawakami, Yuji Matsubara, Taichi Tsuji, Tetsuya Ohara, Yoshito Katayama, Naoki Ishiguro, Tokumi Kanemura
STUDY DESIGN: Retrospective clinical study. OBJECTIVE: To investigate adjacent segment degeneration (ASD) at 5 years after L4/5 posterior lumbar interbody fusion with pedicle screw instrumentation and L4/5 decompression surgery using plain radiographs, computed tomography (CT), and magnetic resonance imaging (MRI), with the evaluation of annual changes on MRI. SUMMARY OF BACKGROUND DATA: Methods of evaluation have been inconsistent among studies of ASD...
November 2016: Clinical Spine Surgery
Qing Yue, Tyson Hale, Aaron Knecht, Jennifer Laidacker
BACKGROUND: Foot drop secondary to L5 root injury is a rare complication associated with lumbar surgery. To date, it is still not clear whether intraoperative neuromonitoring can detect such an injury. CASE DESCRIPTION: A 54-year-old man who had had bilateral chronic L5 radiculopathy underwent L4-S1 lumbosacral decompression and fusion. During the surgery, the patient lose transcranial electrical motor evoked potential (tceMEPs) from left tibialis anterior (TA) at the time of L5-S1 intervertebral cage placement...
October 14, 2016: World Neurosurgery
Javier Quillo-Olvera, Javier Quillo-Reséndiz, Carlos-Francisco Gutiérrez-Partida, Manuel Rodríguez-García
BACKGROUND: Arachnoid cysts of spine are a very rare occurrence. The aetiology still remains unclear, but the most accepted explanation is the existence of areas of weakness in the spinal dura. Symptoms depend on the location in the spine. Magnetic resonance imaging is used for its diagnosis. Management depends of clinical presentation, and the surgery is reserved for patients with neurological impairment. CLINICAL CASE: A case is described of 67 year-old male with myelopathy and radiculopathy symptoms, both diagnosed simultaneously...
October 14, 2016: Cirugia y Cirujanos
Chang-Qing Zhao, Wei Ding, Kai Zhang, Jie Zhao
BACKGROUND: Large lumbar or lumbosacral (LS) disc herniations usually expand from the paramedian space to the neuroforamen and compress both the transversing (lower) and the exiting (upper) nerve roots, thus leading to bi-radicular symptoms. Bi-radicular involvement is a statistically significant risk factor for poor outcome in patients presenting with far lateral or foraminal disc herniation after facet preserving microdecompression. There is evidence showing that patients suffering from large lumbar disc herniations treated with interbody fusion have significant superior results in comparison with those who received a simple discectomy...
September 2016: Indian Journal of Orthopaedics
Andreas Kiilerich Andresen, Carsten Ernst, Mikkel Ø Andersen
Lumbar spinal stenosis is the most common reason for spinal surgery in Denmark. Lumbar spinal stenosis is a clinical syndrome of pain in the buttocks or lower extremities, with or without back pain. It is associated with reduced space available for the neural and vascular elements of the lumbar spine. The condition is often exacerbated by standing, walking or lumbar extension and relieved by forward flexion. The options for non-surgical management include drugs and physiotherapy. Treatment outcomes seem to be better for surgical neural decompression than for non-operative treatment...
October 10, 2016: Ugeskrift for Laeger
A Spallone, M Çelniku
A 49 years-old man came to our attention with severe flaccid paraparesis occurring 10 days before, almost immediately after he had immerged his legs in boiling water for treating his severe left lombo-crural pain. This was known to be due to a right L3-L4 herniated disk diagnosed by MRI. At the examination he showed severe motor paresis and absent reflexes of his lower limbs, whilst crural pain was very mild and sensation and urinary function were unaffected. The results of his neurological examination led us to suspect an acute motor axon degeneration related to the heating shock...
October 11, 2016: World Neurosurgery
Abolfazl Rahimizadeh, Housain Soufiani, Valliolah Hassani, Ava Rahimizadeh
In this study the authors report the first example of spinal pseudarthrosis in a patient with ochronosis, and they describe the application of posterior-only 360° surgery as an alternative approach to combined anterior-posterior surgery in the management of pseudarthrosis of an ankylosed spine, regardless of its etiology. Spinal involvement in ochronosis produces loss of flexibility and ankylosis of thoracic and lumbar segments. Pseudarthrosis is a serious complication of the diseases that present with ankylosis of the spine...
October 14, 2016: Journal of Neurosurgery. Spine
Ikemefuna Onyekwelu, Steven D Glassman, Anthony L Asher, Christopher I Shaffrey, Praveen V Mummaneni, Leah Y Carreon
OBJECTIVE Prior studies have shown obesity to be associated with higher complication rates but equivalent clinical outcomes following lumbar spine surgery. These findings have been reproducible across lumbar spine surgery in general and for lumbar fusion specifically. Nevertheless, surgeons seem inclined to limit the extent of surgery, perhaps opting for decompression alone rather than decompression plus fusion, in obese patients. The purpose of this study was to ascertain any difference in clinical improvement or complication rates between obese and nonobese patients following decompression alone compared with decompression plus fusion for lumbar spinal stenosis (LSS)...
October 14, 2016: Journal of Neurosurgery. Spine
Kae Sian Tay, Anupreet Bassi, William Yeo, Wai Mun Yue
BACKGROUND CONTEXT: There is no current literature comparing outcomes of patients with and without lumbar scoliosis having neurological symptoms undergoing Minimally Invasive Transforaminal Lumbar Interbody Fusion (MIS TLIF) technique. PURPOSE: To determine whether associated lumbar scoliosis will result in different clinical, radiological and operative outcomes in patients undergoing focal MISTLIF for neurogenic symptoms, without specific correction of the scoliosis...
October 7, 2016: Spine Journal: Official Journal of the North American Spine Society
Jonathan M Weimer, Martin Marinov, Rafi Avitsian
A 58-year old male with grade II L4-L5 spondylolisthesis and degenerative changes presented for single level transforaminal lumbar interbody fusion. During decompression of the L4 foramina, distraction of the disc space, and placement of the interbody cage and pedicle screws, episodes of extreme bradycardia with up to 5 seconds of asystole were detected on both EKG and invasive hemodynamic monitoring. The events correlated with and could possibly be a result of traction on the dura. Lumbar spinal surgery may be associated with electrophysiological and hemodynamic abnormalities, and anesthesia providers should be aware of such possibilities and the need to respond appropriately with sympathomimetic or vagolytic interventions...
October 7, 2016: World Neurosurgery
Yong-Hyun Hwang, Hee-Chun Lee, Jae-Hoon Lee
OBJECTIVE: To examine the technical feasibility of percutaneous endoscopic pediculectomy using a lateral approach and to evaluate its use for decompression and examination of the thoracic and lumbar spinal canals in small dogs. STUDY DESIGN: Experimental study. ANIMALS: Clinically normal adult dogs (n=10). METHODS: After optimizing the technique in cadavers, percutaneous endoscopic pediculectomy was performed using a lateral approach to the thoracic (T12) or lumbar (L2) vertebrae in 5 dogs each...
October 6, 2016: Veterinary Surgery: VS
Agnete Gulati, Tore Solberg, Charalampis Giannadakis, Mari Hoff, Glenn Haugeberg, Oystein Nygaard, Sasha Gulati
OBJECTIVE: To compare clinical outcomes following microdecompression surgery or laminectomy for central lumbar spinal stenosis (LSS) between patients with rheumatoid arthritis (RA) and patients without rheumatic disease. MATERIAL AND METHODS: Data were collected from the Norwegian Registry for Spine Surgery. The primary outcome was change in the Oswestry Disability Index (ODI) score at 1 year. The secondary endpoints were health-related quality of life that was measured using the Euro-Qol-5D (EQ-5D), back pain numerical rating scale (NRS), leg pain NRS, and complications...
June 2016: Eur J Rheumatol
Erlick A C Pereira, Mohammad Farwana, Khai S Lam
Spinal stenosis and low-grade spondylolisthesis produce symptoms of neural compression that can be treated with extreme lateral lumbar interbody fusion (XLIF) via indirect decompression. This study aimed to investigate whether the restoration of disc dimensions would relieve symptoms of radiculopathy, claudication and back pain. In this retrospective study, patients undergoing XLIF surgery for relief of radicular symptoms or degenerative disc disease were included. Radiologically proven changes were used to assess the modes of degeneration...
October 1, 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
F C Heider, H M Mayer
OBJECTIVE: Herniated disc tissue removal to decompress the spinal nerve/cauda equina. Minimization of iatrogenic trauma and associated injuries. INDICATIONS: Conservative treatment did not sufficiently improve clinical symptoms. This is true for progressive or persisting neurological deficits, as well as for persisting pain which alters the quality of the patient`s life. Results of surgery are strongly dependent on the preoperative duration of symptoms. Paramount is the "timing" of surgery: poorer surgical results associated with increasing preoperative duration of symptoms...
September 29, 2016: Operative Orthopädie und Traumatologie
M D O'Sullivan, D Abdullah, M Jadaan, E Rahall, A Devitt, J P McCabe
The aim of this study was to determine the changes in both the short and long term, in the trends within the practice of spinal surgery in Galway University Hospitals (GUH) over a seven year period, January 2005 to January 2013. The absolute number of spinal surgery cases has increased from 147 in 2005, to 257 cases by 2013. Multiple level spine surgery accounts for 51% (131) of all cases by 2013, which is an increase from 31% (45) in 2005. On analysis of the trends within spinal surgery during the study period, a statistically significant (p<0...
2016: Irish Medical Journal
Hiroshi Nomura
No abstract text is available yet for this article.
June 2016: J Spine Surg
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