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neurogenic claudication

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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
#1
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
#2
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
#3
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
#4
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
#5
Xiaofei Cheng, Feng Zhang, Kai Zhang, Xiaojiang Sun, Changqing Zhao, Hua Li, Yan Michael Li, Jie Zhao
OBJECTIVE: This study investigated the ability of transforaminal lumbar interbody fusion (TLIF) to improve lumbar lordosis (LL). METHODS: Ninety-two patients receiving single-level TLIF due to lumbar degenerative disease were divided into low back pain, radiculopathy and neurogenic claudication group according to their symptoms. Preoperative and postoperative measures including segmental LL (SLL), whole LL (WLL), pelvic incidence (PI), pelvic tilt (PT), thoracic kyphosis (TK), sagittal vertical axis (SVA), visual analog scale (VAS) for back and leg pain and Oswestry Disability Index (ODI) were used for evaluation of radiographic and clinical outcomes...
October 4, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28973638/percutaneous-interspinous-spacer-vs-decompression-in-patients-with-neurogenic-claudication-an-alternative-in-selected-patients
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
https://www.readbyqxmd.com/read/28690952/targeted-radiofrequency-ablation-as-an-adjunct-in-treatment-of-lumbar-facet-cysts
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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