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neurogenic claudication

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https://www.readbyqxmd.com/read/28923427/minimally-invasive-versus-open-surgery-for-lumbar-synovial-cysts
#1
Pierluigi Vergara, Christopher Yusuf Akhunbay-Fudge, Mark Robert Kotter, Rodney John Charles Laing
OBJECTIVE: Lumbar synovial cysts are relatively infrequent. Historically, these benign lesions have been treated with open excision, sometimes associated with fusion. The aim of this study is to compare Minimally Invasive Surgery (MIS) with Open Surgery (OS) for the treatment of lumbar synovial cysts. METHODS: Retrospective review of patients who underwent minimally invasive or open excision of lumbar synovial cysts. Clinical outcomes, recurrence rate and surgical complications were compared in the 2 groups...
September 15, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28919727/five-year-durability-of-stand-alone-interspinous-process-decompression-for-lumbar-spinal-stenosis
#2
Pierce D Nunley, Vikas V Patel, Douglas G Orndorff, William F Lavelle, Jon E Block, Fred H Geisler
BACKGROUND: Lumbar spinal stenosis is the most common indication for spine surgery in older adults. Interspinous process decompression (IPD) using a stand-alone spacer that functions as an extension blocker offers a minimally invasive treatment option for intermittent neurogenic claudication associated with spinal stenosis. METHODS: This study evaluated the 5-year clinical outcomes for IPD (Superion(®)) from a randomized controlled US Food and Drug Administration (FDA) noninferiority trial...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/28796547/do-superior-or-inferior-interlaminar-approach-or-bevel-orientation-predispose-to-nonepidural-needle-penetration
#3
Nicholas A Koontz, Richard H Wiggins, Gregory J Stoddard, Lubdha M Shah
OBJECTIVE: There is a paucity of evidence-based literature regarding the advantages and disadvantages of the interlaminar approach and needle bevel orientation for performing a lumbar interlaminar epidural steroid injection (ESI). The purpose of this study was to determine if superior versus inferior lamina approach, needle bevel tip orientation, or both may predispose to inadvertent nonepidural penetration during lumbar interlaminar ESI. SUBJECTS AND METHODS: A prospective study was performed of patients with low back pain with or without radicular pain or neurogenic claudication referred for lumbar interlaminar ESI...
August 10, 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28781912/nursing-review-section-of-surgical-neurology-international-part-1-lumbar-disc-disease
#4
Nancy E Epstein, Renee D Hollingsworth
BACKGROUND: Patients with lumbar disc disease may present with low back pain, pain that radiates down into the lower extremity (radiculopathy), and leg pain that increases with ambulation (neurogenic claudication). Patients may first undergo diagnostic studies [(magnetic resonance imaging (MRI) and computed tomographic (CT) examinations] to determine whether there is any significant nerve root or thecal sac compression. METHODS: Increasingly, patients with low back pain with/without radiculopathy are being screened by nurses rather than by neurologists or neurosurgeons/orthopedists...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28748488/association-between-paraspinal-muscle-morphology-clinical-symptoms-and-functional-status-in-patients-with-lumbar-spinal-stenosis
#5
Maryse Fortin, Àron Lazáry, Peter Paul Varga, Michele C Battié
PURPOSE: Lumbar spinal stenosis (LSS) is a disabling condition associated with narrowing of the spinal canal or vertebral foramina. Paraspinal muscle atrophy and fatty infiltration have been reported in patients with chronic LBP and disc herniation. However, very few imaging studies have examined paraspinal muscle morphology and composition in patients with LSS. The purpose of this study was to investigate the association of paraspinal muscle size, composition and asymmetry with functional status in patients with LSS...
July 26, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28702785/changes-in-dural-sac-caliber-with-standing-mri-improve-correlation-with-symptoms-of-lumbar-spinal-stenosis
#6
Yvonne Yan On Lau, Ryan Ka Lok Lee, James Francis Griffith, Carol Lai Yee Chan, Sheung Wai Law, Kin On Kwok
PURPOSE: Weight bearing does alter the dimension of lumbar spinal canal, but no study has analyzed its clinical correlation. This study aims to evaluate whether the changes in dural sac cross-sectional area (DSCA) and sagittal anteroposterior (AP) diameter on standing magnetic resonance imaging (MRI) correlate better with clinical symptoms of lumbar spinal stenosis. METHODS: Seventy consecutive patients with neurogenic claudication were prospectively recruited to undergo a 0...
July 12, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28690952/targeted-radiofrequency-ablation-as-an-adjunct-in-treatment-of-lumbar-facet-cysts
#7
Jesse Hatgis, Michelle Granville, Aldo Berti, Robert E Jacobson
Lumbar facet cysts are frequently found in patients with facet degeneration and segmental instability. When the facet cyst is localized in the neural foramina and lateral recess or becomes large, it can cause radiculopathy or neurogenic claudication. These symptomatic cysts are typically treated interventionally with drainage and a corticosteroid injection or attempts via overinflation to rupture the cyst; however, these procedures have a significant recurrence rate (up to 50%) and often need to be repeated or lead to lumbar surgery if unsuccessful...
June 6, 2017: Curēus
https://www.readbyqxmd.com/read/28688062/giant-thoracic-discs-treatment-outcome-and-follow-up-of-33-patients-in-a-single-centre
#8
Saurabh Kapoor, Meriem Amarouche, Farah Al-Obeidi, Jean Marie U-King-Im, Nick Thomas, David Bell
PURPOSE: To help guide treatment strategies and create insight into functional outcomes in patients with Giant herniated thoracic discs (GHTD), which are defined as occupying more than 40% of spinal canal. METHODS: Authors did a retrospective analysis of prospective cohort of 33 cases of GHTD, using clinical letters, notes, and telephonic questionnaires to determine their pre and postoperative functional status, surgical details, and complication rates. 16 males and 17 females operated between 2006 and 2014 were included in the study...
July 7, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28658837/leriche-syndrome-acute-onset-painful-paraplegia-of-vascular-origin-with-catastrophic-consequences
#9
Sampathkumar Mahadevappa Mahendrakar, Harpreet Singh Sandhu, Azizullah Hafizullah Khan, Yunus Shafi Loya
Acute Aorto-Iliac Occlusive Disease (AIOD) is a rare clinical entity which when presents with buttock claudication, erectile dysfunction and absent femoral pulses is termed as Leriche syndrome. A 59-year-old male patient with past history of smoking and dyslipidaemia presented with acute onset lower back pain, paraplegia, intense lower limb pain and was initially evaluated for compressive myelopathy. On further clinical examination there were absent femoral pulses and Computed Tomography (CT) aortogram was done which confirmed the diagnosis of diffuse AIOD...
May 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28604581/vascular-tos-creating-a-protocol-and-sticking-to-it
#10
REVIEW
Meena Archie, David Rigberg
Thoracic Outlet Syndrome (TOS) describes a set of disorders that arise from compression of the neurovascular structures that exit the thorax and enter the upper extremity. This can present as one of three subtypes: neurogenic, venous, or arterial. The objective of this section is to outline our current practice at a single, high-volume institution for venous and arterial TOS. VTOS: Patients who present within two weeks of acute deep vein thrombosis (DVT) are treated with anticoagulation, venography, and thrombolysis...
June 10, 2017: Diagnostics
https://www.readbyqxmd.com/read/28600006/is-there-still-a-role-for-interspinous-spacers-in-the-management-of-neurogenic-claudication
#11
REVIEW
Vijay M Ravindra, Zoher Ghogawala
Lumbar spinal stenosis with neurogenic claudication is prevalent in the elderly population. Decompression for this condition is the operation most commonly used to treat older patients. Because of the risks associated with open decompression procedures, particularly in older patients with comorbidities, minimally invasive procedures with implantation of interspinous process devices have been developed. This article reviews the current role of interspinous spacers in the treatment of lumbar spinal stenosis with neurogenic claudication and discusses the body of literature surrounding this treatment alternative...
July 2017: Neurosurgery Clinics of North America
https://www.readbyqxmd.com/read/28598295/pelvic-retroversion-a-compensatory-mechanism-for-lumbar-stenosis
#12
Sina Pourtaheri, Akshay Sharma, Jason Savage, Iain Kalfas, Thomas E Mroz, Edward Benzel, Michael P Steinmetz
OBJECTIVE The flexed posture of the proximal (L1-3) or distal (L4-S1) lumbar spine increases the diameter of the spinal canal and neuroforamina and can relieve symptoms of neurogenic claudication. Distal lumbar flexion can result in pelvic retroversion; therefore, in cases of flexible sagittal imbalance, pelvic retroversion may be compensatory for lumbar stenosis and not solely compensatory for the sagittal imbalance as previously thought. The authors investigate underlying causes for pelvic retroversion in patients with flexible sagittal imbalance...
August 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28586588/outcome-analysis-of-two-different-injection-solutions-for-epidural-injection-in-radicular-lumbar-backache-syndromes
#13
Muhammad Saqib, Sajid Nazir Bhatti, Muhammad Ayaz Khan, Khalid Samad, Muhammad Mukhtar Khan, Ehtisham Mukhtar Khan Afridi, Rubaiqa Khan, Muhammad Imran Khan
BACKGROUND: Backache is a significant source of disability and suffering in our society. The treatment modalities need continued enhancement in order to achieve the desired goals of lowering morbidity and financial losses while improving the response of the patient. METHODS: This prospective comparative study was conducted at the department of Orthopaedics and Spine Surgery, Khyber Teaching Hospital Peshawar from July 2013 to June 2015. Two interventional groups were designated; Group 1 was comprised of 54 patients who were injected with epidural bupivacaine plus methylprednisolone while Group 2 included 55 patients who were injected with bupivacaine only...
October 2016: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/28520623/the-sub-crestal-iliac-screw-a-technical-note-describing-a-free-hand-in-line-low-profile-iliac-screw-insertion-technique-to-avoid-side-connector-use-and-reduce-implant-complications
#14
Gabriel Liu, Muhammed Yaser Hasan, Hee-Kit Wong
STUDY-DESIGN: Case-series. OBJECTIVE: Report our modified iliac-screw insertion technique and its clinical outcomes. SUMMARY OF BACKGROUND DATA: Iliac-screws are one of the preferred methods for modern spinopelvic-fixation. However the technique is not without complications, predominantly due to iliac-screw head prominence, leading to pain and revisions. Conventional iliac-screw entry point is sited superficially at the posterior-superior-iliac-spine (PSIS) contributing to screw-head prominence...
May 17, 2017: Spine
https://www.readbyqxmd.com/read/28483706/clinical-classification-criteria-for-radicular-pain-caused-by-lumbar-disc-herniation-the-rapidh-criteria-radicular-pain-caused-by-disc-herniation
#15
Stéphane Genevay, Delphine S Courvoisier, Kika Konstantinou, Francisco M Kovacs, Marc Marty, James Rainville, Michael Norberg, Jean-François Kaux, Thomas D Cha, Jeffrey N Katz, Steven J Atlas
CONTEXT: Classification criteria are recommended for diseases that lack specific biomarkers in order to improve homogeneity in clinical research studies. Since imaging evidence of lumbar disc herniations (LDH) may not be associated with symptoms, clinical classification criteria based upon patient symptoms and physical examination findings are required. PURPOSE: This study aimed to produce clinical classification criteria to identify patients with radicular pain caused by LDH...
May 5, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28479526/superion-interspinous-spacer-treatment-of-moderate-spinal-stenosis-4-year-results
#16
Pierce D Nunley, Vikas V Patel, Douglas G Orndorff, William F Lavelle, Jon E Block, Fred H Geisler
OBJECTIVE: To determine 4-year clinical outcomes in patients with moderate lumbar spinal stenosis treated with minimally invasive stand-alone interspinous process decompression using the Superion device. METHODS: The 4-year Superion data were extracted from a randomized, controlled Food and Drug Administration investigational device exemption trial. Patients with intermittent neurogenic claudication relieved with back flexion who failed at least 6 months of nonsurgical management were enrolled...
August 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28467568/-leriche-syndrome
#17
Serdar Demirgan, Abdullah Tolga Şitilci, Sezen Solak, Mehmet Salih Sevdi, Kerem Erkalp, Emin Köse
Leriche syndrome is a disease characterized by thrombotic occlusion in the aorta, frequently in the distal renal artery. Classic symptoms of this syndrome include pain in the lower extremities emerging during activity (claudication), impalpability of femoral pulses, and impotency in male patients. Definitive diagnosis of claudication due to insufficient circulation as well as claudication that is neurogenic in origin, is difficult. Medical history, physical examination, and monitoring methods are important for definitive diagnosis...
January 2017: Aǧrı: Ağrı (Algoloji) Derneği'nin Yayın Organıdır, the Journal of the Turkish Society of Algology
https://www.readbyqxmd.com/read/28443168/an-iranian-version-of-the-fukushima-lumbar-spinal-stenosis-scale-fls-25-a-validation-study
#18
Parisa Azimi, Ali Montazeri
STUDY DESIGN: Cross-sectional study. PURPOSE: To translate and validate the Fukushima lumbar spinal stenosis (LSS) scale 25 (FLS-25) for use in Iran. OVERVIEW OF LITERATURE: Tools measuring patient-reported outcomes should satisfy certain psychometric properties. METHODS: FLS-25 is a self-administered scale for evaluating symptoms of LSS. A forward-backward procedure was applied to translate the questionnaire from English into Persian...
April 2017: Asian Spine Journal
https://www.readbyqxmd.com/read/28435923/bone-bridge-formation-across-the-neuroforamen-14-years-after-instrumented-fusion-for-isthmic-spondylolisthesis-a-case-report
#19
Joel Louis Lim, Kimberly-Anne Tan, Hwee Weng Dennis Hey
This case report describes the first case of a bone bridge formation across the left L5/S1 neuroforamen after instrumented posterolateral fusion for L5/S1 isthmic spondylolisthesis. Our patient was a 70-year-old lady who had grade 2, L5/S1 isthmic spondylolisthesis and bilateral S1 nerve root compression. She suffered from mechanical low back pain and neurogenic claudication, with radicular pain over both S1 dermatomes. She underwent in-situ, instrumented, posterolateral fusion and was asymptomatic for more than 13 years before developing progressive onset of left radicular pain over the L5 dermatome...
March 2017: Journal of Spine Surgery (Hong Kong)
https://www.readbyqxmd.com/read/28427985/ureter-injury-as-a-complication-of-oblique-lumbar-interbody-fusion
#20
Hyeong-Jin Lee, Jin-Sung Kim, Kyeong-Sik Ryu, Choon Keun Park
BACKGROUND: Oblique lumbar interbody fusion is a commonly used surgical method of achieving lumbar interbody fusion. There have been some reports about complications of oblique lumbar interbody fusion at the L2-L3 level. However, to our knowledge, there have been no reports about ureter injury during oblique lumbar interbody fusion. We report a case of ureter injury during oblique lumbar interbody fusion to share our experience. CASE DESCRIPTION: A 78-year-old male patient presented with a history of lower back pain and neurogenic intermittent claudication...
June 2017: World Neurosurgery
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