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neurogenic claudication

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https://www.readbyqxmd.com/read/29319605/epidural-hematoma-following-interlaminar-epidural-injection-in-patient-taking-aspirin
#1
Rebecca A Sanders, Markus A Bendel, Susan M Moeschler, William D Mauck
OBJECTIVE: We present a case report of a patient who developed an epidural hematoma following an interlaminar epidural steroid injection with no risk factors aside from old age and aspirin use for secondary prevention. CASE REPORT: A 79-year-old man developed an epidural hematoma requiring surgical treatment following an uncomplicated interlaminar epidural steroid injection performed for neurogenic claudication. In the periprocedural period, he continued aspirin for secondary prophylaxis following a myocardial infarction...
January 9, 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29290128/short-term-outcomes-of-lateral-lumbar-interbody-fusion-without-decompression-for-the-treatment-of-symptomatic-degenerative-spondylolisthesis-at-l4-5
#2
Peter G Campbell, Pierce D Nunley, David Cavanaugh, Eubulus Kerr, Philip Andrew Utter, Kelly Frank, Marcus Stone
OBJECTIVE Recently, authors have called into question the utility and complication index of the lateral lumbar interbody fusion procedure at the L4-5 level. Furthermore, the need for direct decompression has also been debated. Here, the authors report the clinical and radiographic outcomes of transpsoas lumbar interbody fusion, relying only on indirect decompression to treat patients with neurogenic claudication secondary to Grade 1 and 2 spondylolisthesis at the L4-5 level. METHODS The authors conducted a retrospective evaluation of 18 consecutive patients with Grade 1 or 2 spondylolisthesis from a prospectively maintained database...
January 2018: Neurosurgical Focus
https://www.readbyqxmd.com/read/29288862/variability-in-surgical-treatment-of-spondylolisthesis-among-spine-surgeons
#3
Daniel Lubelski, Vincent Alentado, Seth Williams, Colin O'Rourke, Nancy Obuchowski, Jeffrey C Wang, Michael Steinmetz, Alfred Melillo, Edward Benzel, Michael Modic, Robert Quencer, Thomas Mroz
BACKGROUND: There are a multitude of treatments for low grade lumbar spondylolisthesis. There are no clear guidelines for the optimal approach. OBJECTIVE: To identify the surgical treatment patterns for spondylolisthesis, among United States spine surgeons METHODS: 445 US spine surgeons completed a survey of clinical/radiographic case scenarios on patients with lumbar spondylolisthesis with neurogenic claudication with (S+BP) or without (S-BP) associated mechanical back pain...
December 27, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29245270/spondylectomy-and-lateral-lumbar-interbody-fusion-for-thoracolumbar-kyphosis-in-an-adult-with-achondroplasia-a-case-report
#4
Masashi Miyazaki, Shozo Kanezaki, Naoki Notani, Toshinobu Ishihara, Hiroshi Tsumura
RATIONALE: Fixed thoracolumbar kyphosis with spinal stenosis in adult patients with achondroplasia presents a challenging issue. We describe the first case in which spondylectomy and minimally invasive lateral access interbody arthrodesis were used for the treatment of fixed severe thoracolumbar kyphosis and lumbar spinal canal stenosis in an adult with achondroplasia. PATIENT CONCERNS: A 61-year-old man with a history of achondroplastic dwarfism presented with low back pain and radiculopathy and neurogenic claudication...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29184704/surgical-nuances-of-circumferential-lumbar-spondylectomy-a-case-report-and-short-literature-review
#5
Daniel Diaz-Aguilar, Sergei Terterov, Rudi Scharnweber, Harsimran Brara, Alex Tucker, Catherine Merna, Stephanie Wang, Shayan Rahman
Background: Chordomas are uncommon malignant bone tumors that are often minimally symptomatic for several years. By the time they are diagnosed, these lesions are typically large, involve major neural, bony, and vascular structures, and are no longer readily resectable. This leads to a high recurrence rate. Case Description: In this case report, we present a 67-year-old male with nonmechanical axial back pain, neurogenic claudication, and a large mass centered at the L3 level on magnetic resonance imaging consistent with a locally invasive chordoma...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/29179752/characteristics-and-determinants-of-clinical-symptoms-in-radiographic-lumbar-spinal-stenosis-in-a-tertiary-health-care-centre-in-sub-saharan-africa
#6
Marie Doualla-Bija, Mbeng Ashu Takang, Emmanuella Mankaa, Jude Moutchia, Pierre Ongolo-Zogo, Henry Luma-Namme
BACKGROUND: Lumbar spinal stenosis (LSS) refers to narrowing of the lumbar central spinal canal, lateral recess, and/or neuro-foramina. Radiographic LSS plays an important role in clinical LSS but is not solely accountable for the presence of symptoms. We sought to characterise clinical LSS and to determine factors associated with presence of symptoms of LSS in patients with radiographic LSS in a sub Saharan Africa setting. METHODS: After prior ethical clearance, a case control study was done in a tertiary hospital in Douala-Cameroon, including 105 patients with radiographic LSS: 57 with symptoms of LSS (cases) and 58 with no symptoms (controls)...
November 28, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29174237/midline-ligamentum-flavum-cyst-of-the-lumbar-spine-a-case-report
#7
Kevin Shah, Daniel Segui, Sergio Gonzalez-Arias
BACKGROUND: Ligamentum flavum cysts are thought to develop due to facet joint hypermobility however the etiology of these lesions is not completely elucidated. These cysts may lead to compressive pathologies of the spine requiring surgical intervention. CASE REPORT: We report the case of a 63-year-old male with chronic back pain and progressive neurogenic claudication for 6 months. He was found to have a ligamentum flavum cyst situated along the dorsal midline of the lumbar spinal canal contributing to spinal stenosis...
November 23, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29133325/minimally-invasive-surgery-versus-open-surgery-in-the-treatment-of-lumbar-spondylolisthesis-study-protocol-of-a-multicentre-randomised-controlled-trial-misos-trial
#8
Mark P Arts, Jasper Fc Wolfs, Jos Ma Kuijlen, Godard Cw de Ruiter
INTRODUCTION: Patients with symptomatic spondylolisthesis are frequently treated with nerve root decompression, in addition to pedicle screw fixation and interbody fusion. Minimally invasive approaches are gaining attention in recent years, although there is no clear evidence supporting the proclamation of minimally invasive spine surgery (MISS) being better than open surgery. We present the design of the MISOS (Minimal Invasive Surgery versus Open Surgery) trial on the effectiveness of MISS versus open surgery in patients with degenerative or spondylolytic spondylolisthesis...
November 12, 2017: BMJ Open
https://www.readbyqxmd.com/read/29119044/nursing-review-of-diagnosis-and-treatment-of-lumbar-degenerative-spondylolisthesis
#9
Nancy E Epstein, Renee D Hollingsworth
Background: In the lumbar spine, degenerative spondylolisthesis or degenerative (not traumatic) slippage of one vertebral body over another is divided into 4 grades - grade I (25%), grade II (50%), grade III (75%), and grade IV (100%). Dynamic X-rays, magnetic resonance (MR), and computed tomography (CT) scans document the slip secondary to arthritic changes of the facet joint plus stenosis, ossification of the yellow ligament, disc herniations, and synovial cysts. MR best demonstrates soft tissue pathology whereas CT better delineates ossific/calcified disease...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/29031994/clinical-classification-criteria-for-neurogenic-claudication-caused-by-lumbar-spinal-stenosis-the-n-class-criteria
#10
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
BACKGROUND CONTEXT: Since imaging findings of lumbar spinal stenosis (LSS) may not be associated with symptoms, clinical classification criteria based on patient symptoms and physical examination findings are needed. PURPOSE: To develop clinical classification criteria that identify patients with neurogenic claudication (NC) caused by LSS. STUDY DESIGN: Two stage process. Phase 1: Delphi process; Phase 2: cross-sectional study. PATIENT SAMPLE: Outpatients recruited from spine clinics in 5 countries...
October 12, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29019641/spine-conditions-lumbar-spinal-stenosis
#11
REVIEW
Steven D Trigg, Zachary Devilbiss
Lumbar spinal stenosis (LSS) is a frequent cause of chronic low back and lower extremity pain in older patients. Symptomatic LSS typically is described as neurogenic claudication consisting of pain, weakness, numbness, and/or fatigue arising in the back and radiating into the buttock, thigh, or lower leg. The diagnosis is complicated by lack of reliable clinical or x-ray criteria. North American Spine Society guidelines recommend magnetic resonance imaging study without contrast to confirm anatomic narrowing of the spinal canal or nerve root impingement...
October 2017: FP Essentials
https://www.readbyqxmd.com/read/28987851/effect-of-single-level-transforaminal-lumbar-interbody-fusion-on-segmental-and-overall-lumbar-lordosis-in-patients-with-lumbar-degenerative-disease
#12
Xiaofei Cheng, Feng Zhang, Kai Zhang, Xiaojiang Sun, Changqing Zhao, Hua Li, Yan Michael Li, Jie Zhao
OBJECTIVE: To investigate the ability of transforaminal lumbar interbody fusion (TLIF) to improve lumbar lordosis (LL). METHODS: In this retrospective study, 92 patients undergoing single-level TLIF to treat lumbar degenerative disease were divided into a low back pain, radiculopathy, and neurogenic claudication group according to their symptoms. Preoperative and postoperative measures, including segmental LL, whole LL, pelvic incidence (PI), pelvic tilt, thoracic kyphosis, sagittal vertical axis, visual analog scale for back and leg pain, and Oswestry Disability Index, were used to evaluate radiographic and clinical outcomes...
October 5, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28973638/percutaneous-interspinous-spacer-vs-decompression-in-patients-with-neurogenic-claudication-an-alternative-in-selected-patients
#13
Bernhard Meyer, Adad Baranto, Frederic Schils, Frederic Collignon, Bjorn Zoega, Leong Tan, Jean-Charles LeHuec
BACKGROUND: Standalone interspinous process devices (IPDs) to treat degenerative lumbar spinal stenosis with neurogenic intermittent claudication (NIC) have shown ambiguous results in the literature. OBJECTIVE: To show that a minimally invasive percutaneous IPD is safe and noninferior to standalone decompressive surgery (SDS) for patients with degenerative lumbar spinal stenosis with NIC. METHODS: A multicenter, international, randomized, controlled trial (RCT) was con- ducted...
June 26, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28966827/spontaneous-pseudomeningocele-associated-with-lumbar-spondylolisthesis-a-case-report-and-review-of-the-literature
#14
Gonçalo Novais, Bernardo Ratilal, Lia Pappamikail, Pedro Branco, Nuno Reis
BACKGROUND: Pseudomeningocele, an extradural collection of cerebrospinal fluid (CSF), has only been rarely reported to occur spontaneously in conjunction with isthmic spondylolisthesis (with lysis) in the lumbar spine. CASE DESCRIPTION: A 68-year-old male presented with low back pain and neurogenic claudication of several years duration without any history of trauma, epidural spine injections, or spine surgery. Lumbosacral magnetic resonance imaging (MRI) revealed a grade-I L4-L5 isthmic spondylolisthesis with spinal canal narrowing and a posterior paravertebral collection consistent with CSF...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28923427/minimally-invasive-versus-open-surgery-for-lumbar-synovial-cysts
#15
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
#16
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
#17
RANDOMIZED CONTROLLED TRIAL
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...
October 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28781912/nursing-review-section-of-surgical-neurology-international-part-1-lumbar-disc-disease
#18
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
#19
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...
October 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
#20
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...
October 2017: European Spine Journal
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