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Decompression lumbar

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https://www.readbyqxmd.com/read/28097244/minimising-costs-in-spinal-surgery-is-group-save-testing-justified-in-lumbar-decompression-surgery
#1
William T Wilson, Adam M H Young, Paul Fivey
BACKGROUND: Lumbar microdiscectomy and laminectomy are two of the most common neurosurgical procedures performed worldwide. Current practice still sees pre-operative group and save testing prior to this surgery. The aim of this study was to determine the need for pre-operative group and save and post-operative blood checks. METHODS: Patient archives were reviewed to identify those undergoing primary elective lumbar decompression surgery at the Institute of Neurological Sciences, Queen Elizabeth University Hospital, Glasgow, UK...
December 2016: Journal of Spine Surgery (Hong Kong)
https://www.readbyqxmd.com/read/28092340/decompression-surgery-alone-versus-decompression-plus-fusion-in-symptomatic-lumbar-spinal-stenosis-a-swiss-prospective-multi-center-cohort-study-with-3-years-of-follow-up
#2
Nils H Ulrich, Jakob M Burgstaller, Giuseppe Pichierri, Maria M Wertli, Mazda Farshad, François Porchet, Johann Steurer, Ulrike Held
STUDY DESIGN: Retrospective analysis of a prospective, multicenter cohort study. OBJECTIVE: To estimate the added effect of surgical fusion as compared to decompression surgery alone in symptomatic lumbar spinal stenosis patients with spondylolisthesis. SUMMARY OF BACKGROUND DATA: The optimal surgical management of lumbar spinal stenosis patients with spondylolisthesis remains controversial. METHODS: Patients of the LSOS with confirmed DLSS and spondylolisthesis were enrolled in this study...
January 13, 2017: Spine
https://www.readbyqxmd.com/read/28077887/examination-of-the-predictive-power-of-electromyography-and-urodynamic-study-in-patients-with-cauda-equina-syndrome-horse-tail-syndrome
#3
Mohammadreza Shahmohammadi, Reza Jalil Khoshuod, Alireza Zali, Amir Saied Seddeghi, Nima Mohseni Kabir
BACKGROUND: Cauda equina syndrome is a rare disorder that causes loss of Lumbar plexus function (nerve roots) lower than conus medullaris. No risk factor has been defined for this disease yet. Due to the high morbidity of Cauda equina syndrome and lack of sufficient information about the connection between the disease and urodynamic findings and EMG (Electromyography) findings, the need for this comprehensive study is felt. OBJECTIVE: The aim is to determine the predictive power of findings resulted from urodynamics and electromyography of perineal region and around sphincter in the clinical cure rate of urination in patients with urinary retention followed by Cauda equina syndrome...
October 2016: Acta Informatica Medica: AIM
https://www.readbyqxmd.com/read/28074438/is-there-variation-in-procedural-utilization-for-lumbar-spine-disorders-between-a-fee-for-service-and-salaried-healthcare-system
#4
Andrew J Schoenfeld, Heeren Makanji, Wei Jiang, Tracey Koehlmoos, Christopher M Bono, Adil H Haider
BACKGROUND: Whether compensation for professional services drives the use of those services is an important question that has not been answered in a robust manner. Specifically, there is a growing concern that spine care practitioners may preferentially choose more costly or invasive procedures in a fee-for-service system, irrespective of the underlying lumbar disorder being treated. QUESTIONS/PURPOSES: (1) Were proportions of interbody fusions higher in the fee-for-service setting as opposed to the salaried Department of Defense setting? (2) Were the odds of interbody fusion increased in a fee-for-service setting after controlling for indications for surgery? METHODS: Patients surgically treated for lumbar disc herniation, spinal stenosis, and spondylolisthesis (2006-2014) were identified...
January 10, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28072709/tranexamic-acid-reduces-perioperative-blood-loss-of-posterior-lumbar-surgery-for-stenosis-or-spondylolisthesis-a-randomized-trial
#5
Houyin Shi, Yunsheng Ou, Dianming Jiang, Zhengxue Quan, Zenghui Zhao, Yong Zhu
BACKGROUND: A prospective, randomized, double-blind, placebo-controlled study was performed. The routine usage of TA in spinal surgery is controversial. Only a few studies have focused on patients undergoing posterior lumbar surgery for stenosis or spondylolisthesis, although a large clinical cohort exists in the population. This study aimed to evaluate the effect and safety of TA in reducing perioperative blood loss in posterior lumbar surgery for stenosis or spondylolisthesis. METHODS: 100 eligible patients out of 126 were randomized to receive either a bolus dose of 30 mg/kg TA i...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28068753/retrospective-matched-pair-cohort-study-on-effect-of-bisegmental-fenestration-versus-hemilaminectomy-for-bisegmental-spinal-canal-stenosis-at-l3-l4-and-l4-l5
#6
Julia Schüppel, Friedrich Weber
Background The main symptoms of degenerative lumbar spinal canal stenosis are progressive back pain, spinal claudication, and, occasionally, sensory and motor deficits. Impairments particularly occur during walking, standing, and sitting. Thus social and vocational activities are increasingly restricted, causing considerable suffering for patients. Surgical therapies are superior to conservative ones. This article studies the outcome of 2-level fenestration versus hemilaminectomy for bisegmental spinal stenosis decompression...
January 9, 2017: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/28059982/morbidity-of-adult-spinal-deformity-surgery-in-elderly-has-declined-over-time
#7
Peter G Passias, Gregory W Poorman, Cyrus M Jalai, Brian Neuman, Rafael de la Garza-Ramos, Emily Miller, Amit Jain, Daniel Sciubba, Shearwood McClelland, Louis Day, Subbu Ramachadran, Shaleen Vira, Bassel Diebo, Evan Isaacs, Olivia Bono, Shay Bess, Michael Gerling, Virginie Lafage
STUDY DESIGN: A retrospective review of a prospectively collected database, the Nationwide Inpatient Sample (NIS), years 2003 to 2012. OBJECTIVES: The aim of this study was to examine trends in the management of scoliosis in elderly (age >75 yrs) patients from 2003 to 2012. SUMMARY OF BACKGROUND DATA: Scoliosis incidence rises with increasing age, and age has been shown to be an independent risk factor for surgical complications in scoliosis surgery...
January 4, 2017: Spine
https://www.readbyqxmd.com/read/28059949/the-influence-of-single-level-versus-multilevel-decompression-on-the-outcome-in-multisegmental-lumbar-spinal-stenosis-analysis-of-the-lumbar-spinal-outcome-study-lsos-data
#8
Nils H Ulrich, Jakob M Burgstaller, Ulrike Held, Sebastian Winklhofer, Mazda Farshad, Giuseppe Pichierri, Johann Steurer, François Porchet
STUDY DESIGN: This is prospective multicenter cohort study. OBJECTIVE: To assess whether patients with confirmed multisegmental lumbar spinal stenosis benefit more from a single-level or a multilevel decompression. SUMMARY OF BACKGROUND DATA: In multisegmental lumbar spinal stenotic cases, the decision as to how many levels of stenosis need to be operated to achieve the best possible clinical outcome is still unknown and remains a controversy between spine surgeons...
January 4, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28045239/percutaneous-endoscopic-transpedicle-approach-for-herniated-nucleus-pulposus-in-the-lumbar-hidden-zone
#9
Dong Wang, Hao Pan, Qinfeng Hu, Hang Zhu, Li Zhu, Yongjiang He, Jian Wang, Gaoyong Jia
INTRODUCTION: Although endoscopic procedures for lumbar disc diseases have improved greatly, treating migrated disc herniation is still a challenging task. Because of anatomic limitations, a rigid endoscope cannot effectively reach the herniated nucleus pulposus (HNP) in the hidden zone. The purpose of this study was to describe the transpedicle approach for HNP in the hidden zone using the percutaneous endoscopic lumbar discectomy system and to demonstrate the clinical results. Materials and Surgical Technique: Under fluoroscopy, the percutaneous endoscopic lumbar discectomy cannula is placed on the superior articular process, and a trephine with a diameter of 7...
February 2017: Asian Journal of Endoscopic Surgery
https://www.readbyqxmd.com/read/28043848/surgical-treatment-of-degenerative-spondylolisthesis
#10
REVIEW
P Guigui, E Ferrero
Degenerative spondylolisthesis is a common pathology, often causing lumbar canal stenosis. There is, however, no strong consensus regarding the various medical and surgical treatments available. Surgery is indicated mainly for perceived functional impairment; when the indication is accepted, several questions determine the choice of surgical strategy. Improvement in neurological symptoms is one of the main treatment objectives. For this, it is useful to perform radicular decompression. Some authors recommend indirect decompression by interbody fusion (ALIF, TLIF, XLIF), others by means of an interspinous spacer but the most frequent technique is direct posterior decompression...
December 30, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28040872/cost-effectiveness-of-conservative-versus-surgical-treatment-strategies-of-lumbar-spinal-stenosis-in-the-swiss-setting-analysis-of-the-prospective-multicenter-lumbar-stenosis-outcome-study-lsos
#11
A Aichmair, J M Burgstaller, M Schwenkglenks, J Steurer, F Porchet, F Brunner, M Farshad
PURPOSE: To evaluate the cost-effectiveness of conservative versus surgical treatment strategies for lumbar spinal stenosis (LSS). METHODS: Patients prospectively enrolled in the multicenter Lumbar Stenosis Outcome Study (LSOS) with a minimum follow-up of 12 months were included. Quality adjusted life years (QALY) were calculated based on EQ-5D data. Cost data were retrieved retrospectively. Cost-effectiveness was calculated via decision tree analysis. RESULTS: A total of 434 patients were included, treated surgically (n = 170) or conservatively (n = 264) for LSS...
December 31, 2016: European Spine Journal
https://www.readbyqxmd.com/read/28028447/spinal-epidural-abscess-in-a-patient-with-piriformis-pyomyositis
#12
Gerald S Oh, Hussam Abou-Al-Shaar, Gregory D Arnone, Ashley L Barks, Ziad A Hage, Sergey Neckrysh
BACKGROUND: Spinal epidural abscess resulting from piriformis pyomyositis is extremely rare. Such condition can result in serious morbidity and mortality if not addressed in a timely manner. CASE DESCRIPTION: The authors describe the case of a 19-year-old male presenting with a 2-week history of fever, low back pain, and nuchal rigidity. When found to have radiographic evidence of a right piriformis pyomyositis, he was transferred to our institution for further evaluation...
2016: Surgical Neurology International
https://www.readbyqxmd.com/read/28027388/spinal-anesthesia-in-elderly-patients-undergoing-lumbar-spine-surgery
#13
Noah L Lessing, Charles C Edwards, Charles H Brown, Emily C Ledford, Clayton L Dean, Charles Lin, Charles C Edwards
Spinal anesthesia is increasingly viewed as a reasonable alternative to general anesthesia for lumbar spine surgery. However, the results of spinal anesthesia in elderly patients undergoing lumbar spine decompression and combined decompression and fusion procedures are limited in the literature. The aim of this study was to report a single institution's experience using spinal anesthesia in elderly patients undergoing lumbar spine surgery. A retrospective review was conducted using a prospectively collected database of consecutive lumbar spine surgeries performed under spinal anesthesia in patients 70 years or older at a single center between December 2013 and October 2015...
December 27, 2016: Orthopedics
https://www.readbyqxmd.com/read/28026727/radiological-changes-after-interspinous-dynamic-stabilisation-for-lateral-stenosis-of-lumbar-spinal-canal-a-parallel-group-randomised-trial
#14
J Mohar, M Cimerman
PURPOSE OF THE STUDY Interspinous dynamic stabilisation devices (IDSDs) are used for stabilisation and indirect decompression of the spinal motion segment in minimally invasive treatment of degenerative conditions of lumbar spine. Good methodological quality studies on biomechanical effects of IDSDs are lacking in scientific literature. The purpose of this study was to evaluate the biomechanical effect of dynamic IDSD implantation on a spinal motion segment. MATERIAL AND METHODS We conducted a parallel group randomised trial (RT) on twelve patients, comparing radiological stabilisation and indirect decompression outcome measures between groups of patients with an isolated degenerative condition of L4-L5 motion segment and unilateral L5 nerve root radiculopathy...
2016: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
https://www.readbyqxmd.com/read/28017709/anatomical-analysis-of-the-relation-between-human-ligamentum-flavum-and-posterior-spinal-bony-prominence
#15
Javid Akhgar, Hidetomi Terai, Mohammad Suhrab Rahmani, Koji Tamai, Akinobu Suzuki, Hiromitsu Toyoda, Masatoshi Hoshino, Mitsuhiko Ikebuchi, Sayed Abdullah Ahmadi, Kazunori Hayashi, Hiroaki Nakamura
BACKGROUND: Posterior spinal bony prominences are commonly used as landmarks during posterior spinal surgery; however, the exact relationship of these structures with ligamentum flavum (LF) borders and attachments has not been clarified. MATERIALS AND METHODS: Whole spines were removed en bloc from 20 embalmed human cadavers. Plain radiographs and computed tomography (CT) scans of each whole spine were taken, and then the spine was divided in two parts along the pedicle bases...
December 22, 2016: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/28009771/spontaneous-spinal-subdural-hematoma
#16
Marlijn H de Beer, Marjolein M Eysink Smeets, Hille Koppen
OBJECTIVE: Spinal subdural hematomas (SSDHs) are rare. Causes are (1) posttraumatic, (2) iatrogenic (following surgery or lumbar puncture), (3) spontaneous including underlying malformations or coagulation deficits. With a systematic review of literature we want to shed light on the last group: symptomatology, etiology, treatment and outcome will we discussed. METHODS: Systematic review of literature on PubMed for cases of acute nontraumatic noniatrogenic SSDHs in adults (≥18 y of age)...
January 2017: Neurologist
https://www.readbyqxmd.com/read/28009405/fulminant-idiopathic-intracranial-hypertension-and-venous-stasis-retinopathy-resulting-in-severe-bilateral-visual-impairment
#17
Alexander Voldman, Breanna Durbin, John Nguyen, Brian Ellis, Monique Leys
PURPOSE: To report a complicated case of fulminant idiopathic intracranial hypertension and concomitant venous stasis retinopathy leading to postpapilledema optic atrophy. METHODS: Case report. RESULTS: A 34-year-old morbidly obese woman with a history of idiopathic intracranial hypertension (IIH) presented with a 1-month history of bilateral vision loss, diplopia, and left eye pain after being lost to follow-up for 6 years. Fundus examination revealed florid papilledema with venous tortuosity bilaterally...
December 6, 2016: European Journal of Ophthalmology
https://www.readbyqxmd.com/read/28009223/development-of-an-enhanced-recovery-after-surgery-eras-approach-for-lumbar-spinal-fusion
#18
Michael Y Wang, Peng-Yuan Chang, Jay Grossman
OBJECTIVE Over the past decade, Enhancing Recovery After Surgery (ERAS) programs have been implemented throughout the world across multiple surgical disciplines. However, to date no spinal surgery equivalent has been described. In this report the authors review the development and implementation of a "fast track" surgical approach for lumbar fusion. METHODS The first 42 consecutive cases in which patients were treated with the new surgical procedure were reviewed. A combination of endoscopic decompression, expandable cage deployment, and percutaneous screw placement were performed with liposomal bupivacaine anesthesia to allow the surgery to be performed without general endotracheal anesthesia...
December 23, 2016: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28005935/a-biomechanical-stability-study-of-extraforaminal-lumbar-interbody-fusion-on-the-cadaveric-lumbar-spine-specimens
#19
Song Guo, Cheng Zeng, Meijun Yan, Yingchao Han, Dongdong Xia, Guixin Sun, Lijun Li, Mingjie Yang, Jun Tan
BACKGROUND: Transforaminal lumbar interbody fusion (TLIF) is an effective surgery for lumbar degenerative disease. However, this fusion technique requires resection of inferior facet joint to provide access for superior facet joint resection, which results in reduced lumbar spinal stability and unnecessary trauma. We have previously developed extraforaminal lumbar interbody fusion (ELIF) that can avoid back muscle injury with direct nerve root decompression. This study aims to show that ELIF enhances lumbar spinal stability in comparison to TLIF by comparing lumbar spinal stability of L4-L5 range of motion (ROM) on 12 cadaveric spine specimens after performing TLIF or ELIF...
2016: PloS One
https://www.readbyqxmd.com/read/28005617/lateral-extracavitary-approach-versus-posterior-extensive-circumferential-decompression-in-the-treatment-of-complicated-thoracic-and-lumbar-tuberculous-spondylitis
#20
Khaled Omran, Ahmed S Abdel-Fattah, Ahmed M A Othman, Ahmed O Youssef, Amr Solimen, Mohamed A ElRefai, Ahmed N Saleh, Mohammed Ali
OBJECTIVES AND STUDY DESIGN: The aim of this study was to retrospectively evaluate 45 patients operated upon either by posterior extensive circumferential decompression (PECD) or by the lateral extracavitary (LEC) technique and compare the clinical, radiologic, laboratory, and functional outcomes. SUMMARY OF BACKGROUND: The debate continues on the best decompression-fusion technique for treating complicated spinal tuberculosis. In recent times, the advantages of combined surgery have been successfully achieved using the 1-stage salvage technique, with enough accessibility to all 3 spinal columns...
December 21, 2016: Clinical Spine Surgery
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