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Lumbar And Stenosis

Li-Jun Li, Feng Chang, Yong Hai, Jin-Cai Yang, Cheng Xu, Jie Yuan, Jiu-Qiang Sun, Qing-Hua Wang, Sheng-Qiang Ding
OBJECTIVE: To evaluate clinical effects of lumbar spinal stenosis by endoscopic transforaminal decompression, and to provide a theory basis for selection of surgical candidates. METHODS: From June 2014 to January 2016, clinical data of 87 patients with lumbar spinal stenosis were retrospectively analyzed, including 45 males and 42 females, aged from 25 to 81 years old with an average of 55.14 years old; 8 cases on L₃,₄, 61 cases on L₄,₅, 18 cases on L₅S₁...
July 25, 2018: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Guang-Xun Lin, Kutbuddin Akbary, Vit Kotheeranurak, Javier Quillo-Olvera, Hyun-Jin Jo, Xiao-Wei Yang, Akaworn Mahatthanatrakul, Jin-Sung Kim
OBJECTIVE: To compare the radiological and clinical outcomes between oblique lumbar interbody fusion (OLIF) without laminectomy and minimally invasive transforaminal lumbar interbody fusion (MI-TLIF). METHODS: This is a retrospective study. Between April 2012 and January 2017, twenty-five patients in each of MI-TLIF and OLIF group recruited as matched pairs. Clinical outcomes included visual analog scale (VAS), Oswestry Disability Index (ODI) and satisfaction rates...
August 9, 2018: World Neurosurgery
Zenghui Zhao, Liang Guo, Yong Zhu, Wei Luo, Yunsheng Ou, Zhengxue Quan, Dianming Jiang
BACKGROUND Long-term follow-up results showed that epidural scar formation and adhesion after laminectomy always affected the outcomes of repeat operations. The establishment of a barrier between scar tissue and dura was effective in preventing epidural scar formation. MATERIAL AND METHODS A nano-hydroxyapatite/polyamide66 (n-HA/PA66) artificial lamina was designed and fabricated and used to cover the opened spinal canal in patients who received laminectomy. The visual analogue scale (VAS) and Japanese Orthopedic Association (JOA) Scores, X-ray, computed tomography, and magnetic resonance imaging results were periodically recorded and evaluated...
August 11, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Lei Kong, Xi-Fu Shang, Wen-Zhi Zhang, Li-Qun Duan, Yang Yu, Wei-Jian Ni, Yan Huang
BACKGROUND: Sufficient decompression of the nerve root canal is still regarded as the method of choice when operating on patients with lumbar disc herniation (LDH) with lumbar lateral recess stenosis; however, tissue-sparing procedures are becoming more popular. Endoscopic techniques offer advantages and the benefits of rehabilitation, which have become the standard in many surgical operations when operating on the spine. A significant issue has been the upgrading of instruments to provide enough bone resection under continuous visual control...
August 3, 2018: Der Orthopäde
Takahito Fujimori, Toshitada Miwa, Motoki Iwasaki, Takenori Oda
BACKGROUND: Healthcare costs are a global concern, and cost-effectiveness analyses of interventions have become important. However, data regarding cost-effectiveness are limited to a few medical fields. The purpose of our study was to examine the Japanese universal health insurance system cost per quality-adjusted life year (QALY) for lumbar fenestration surgery. METHODS: Forty-eight patients who underwent fenestration for lumbar degenerative spinal canal stenosis between July 2013 and September 2015 were included...
July 31, 2018: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
Kai-Uwe Lewandrowski
OBJECTIVE: To analyze the positive predictive value of diagnostic 1% lidocaine containing transforaminal epidural steroid injections (TESI) for successful outcome after outpatient endoscopic decompression for lumbar foraminal and lateral recess stenosis. PATIENTS AND METHODS: A retrospective study of 1839 consecutive patients with an average mean follow-up of 33 months that underwent endoscopic transforaminal decompression at 2076 lumbar levels was conducted. The sensitivity, specificity, and positive predictive value of lidocaine containing diagnostic TESI at the intended surgical level were calculated based on the recorded frequency of >50% VAS score reduction, intraoperatively visualized stenosis, and clinical outcomes assessed by Macnab criteria and VAS reduction...
July 24, 2018: Clinical Neurology and Neurosurgery
Evan Rhea, Gazanfar Rahmathulla
BACKGROUND: Facet dislocations, or jumped facets, are part of a spectrum of flexion-distraction spine injuries. Bilateral and unilateral facet dislocations are commonly seen in the cervical spine. Traumatic jumped facets in the lumbar spine are rare injuries, and a majority of these involve the lumbosacral junction. Lumbar facet subluxations occur commonly in younger patients, due to the flexion-distraction forces on the lumbar spine at the time of the injury combined with ligamentous laxity that exists in these patients...
July 31, 2018: World Neurosurgery
Brook Martin, Sohail K Mirza, Nicholas Spina, William R Spiker, Brandon Lawrence, Darrel S Brodke
STUDY DESIGN: Analysis of National Inpatient Sample (NIS), 2004-2015. OBJECTIVE: Describe recent trends in U.S. rates of lumbar fusion procedures and associated costs, by surgical indication. SUMMARY OF BACKGROUND DATA: Spinal fusion is appropriate for spinal deformity and instability, but evidence of effectiveness is limited for primary disc herniation and spinal stenosis without instability. It remains controversial for treatment of axial pain secondary to degenerative disc disease...
August 2, 2018: Spine
Mutsuya Shimizu, Tetsuya Kobayashi, Shizuo Jimbo, Issei Senoo, Hiroshi Ito
PURPOSE: To investigate the surgical outcome of patients with osteophyte-associated dysphagia (OAD) using the functional outcome swallowing scale (FOSS). METHODS: A retrospective chart review of 10 surgical cases of OAD (9 male and 1 female patient; mean age of 65 years) from 1982 to 2017 was performed, and radiographic evaluations were conducted by video fluoroscopic swallow study (VFSS) and conventional radiography. All OAD cases were treated at a single institution, and osteophytes were surgically resected by the anterior approach under gentle retraction of the affected esophagus...
2018: PloS One
Kazuki Sugimoto, Takayuki Nakamura, Takuya Tokunaga, Yusuke Uehara, Tatsuya Okada, Takuya Taniwaki, Toru Fujimoto, Hiroshi Mizuta
Ligamentum flavum (LF) hypertrophy in lumbar spinal canal stenosis (LSCS) is characterized by a loss of elastic fibers and fibrosis. Chronic inflammation is thought to be responsible for the histological change but the mechanism underlying elastic fiber degradation remains unclear. Given that matrix metalloproteinase (MMP)-2 and -9 have elastolytic activity and are partly regulated by inflammatory cytokines such as interleukin (IL)-6, in this study, we investigated whether MMPs mediate LF degeneration using 52 LF samples obtained during lumbar surgery, including 31 LSCS and 21 control specimens...
2018: PloS One
Jennifer C Urquhart, Nabeel Alnaghmoosh, Kevin R Gurr, Stewart I Bailey, Corinne Tallon, Shauna Dehens, M Patricia Rosas Arellano, Christopher S Bailey
STUDY DESIGN: This was a retrospective study of 2 different fusion techniques for the treatment of lumbar degenerative spondylolisthesis. OBJECTIVE: To determine whether posterior lumbar interbody fusion (IF) is associated with improved patient-rated satisfaction and functional outcome when compared with posterolateral fusion (PLF). SUMMARY OF BACKGROUND DATA: IF and PLF are widely used surgical approaches in the treatment of spondylolisthesis...
July 31, 2018: Clinical Spine Surgery
Jae-Hyun Park, Je-Tae Jung, Sang-Jin Lee
BACKGROUND: Surgeries for far-lateral lumbar disc herniation (FLLDH) and foraminal stenosis at the L5/S1 level are very complicated because of its unique structure. The authors have performed unilateral bi-portal endoscopy (UBE) to these lesions because of the good results obtained for other spinal diseases (Park et al. in Orthopedics 40:e779-e783, 2017). METHODS: We described our experience of the surgical treatment for FLLDH and foraminal stenosis. Useful information for pre-, intraop-, and postoperative care is presented...
July 31, 2018: Acta Neurochirurgica
Hussam Abou-Al-Shaar, Owoicho Adogwa, Ankit I Mehta
Lumbar spinal stenosis (LSS) is one of the most common affecting the elderly population that may lead to loss of function and the inability to execute basic activities of daily living. While surgical decompression remains the standard of care, choosing an optimal management strategy is usually guided by a set of clinical, radiological, and measurement indices. However, to date, there is a major uncertainty and discrepancy regarding the methodology used. There is also inconsistent adoption of outcome measures across studies, which may result in huge limitations in predicting the efficacy and cost-effectiveness of different treatment paradigms...
August 2018: Asian Spine Journal
Tomohiro Yamauchi, Kyongsong Kim, Toyohiko Isu, Naotaka Iwamoto, Kazuyoshi Yamazaki, Juntaro Matsumoto, Masanori Isobe
STUDY DESIGN: Retrospective study (level of evidence=3). PURPOSE: We examine the relationship between residual symptoms after discectomy for lumbar disc herniation and peripheral nerve (PN) neuropathy. OVERVIEW OF LITERATURE: Patients may report persistent or recurrent symptoms after lumbar disc herniation surgery; others fail to respond to a variety of treatments. Some PN neuropathies elicit symptoms similar to those of lumbar spine disease...
August 2018: Asian Spine Journal
Kamran Movassaghi, Bryce A Basques, Philip K Louie, Jannat M Khan, Peter B Derman, Michael T Nolte, Justin C Paul, Edward J Goldberg, Howard S An
STUDY DESIGN: Retrospective cohort analysis OBJECTIVE.: To assess whether duration of symptoms (DOS) has an effect on clinical outcomes in patients undergoing lumbar decompression. SUMMARY OF BACKGROUND: The success of surgical interventions for lumbar spinal stenosis varies depending on numerous factors, including DOS. However, existing literature does not provide a clear indication of the outcome of lumbar decompression surgery in regard to DOS secondary to nerve root compression...
July 27, 2018: Spine
Tomasz Lorenc, Piotr Palczewski, Damian Wójcik, Wojciech Glinkowski, Marek Gołębiowski
STUDY DESIGN: Single center before-after case series study. OBJECTIVE: To determine when and in which kind of lower back pathologies, axial-loaded magnetic resonance imaging (MRI) provides additional benefit over recumbent MRI. SUMMARY AND BACKGROUND DATA: Systems simulating physiological axial loading of the spine in patients examined in the supine position have recently been introduced in clinical practice. However, indications for examinations with axial loading have yet to be clearly specified...
August 2018: Spine
Pierce D Nunley, Vikas V Patel, Douglas G Orndorff, William F Lavelle, Jon E Block, Fred H Geisler
Lumbar spinal stenosis has been shown to negatively impact health-related quality of life. Interspinous process decompression (IPD) is a minimally invasive procedure that utilizes a stand-alone spacer to serve as a joint extension blocker to relieve neural compression in patients with spinal stenosis. Using the 5-year results from an FDA randomized controlled trial of IPD, the quality of life in 189 patients treated with the Superion® spacer was evaluated with the SF-12. Physical and mental component summary (PCS, MCS) scores were computed preoperatively and at annual intervals...
2018: Minimally Invasive Surgery
Ziyu Zhou, Caiyun Hou, Dongdong Li, Jianwei Si
BACKGROUND: Degenerative spondylolisthesis (DS) and lumbar spinal stenosis (LSS) are the most common degenerative spinal diseases. The evaluating of spinopelvic sagittal alignment of the two diseases using pelvic radius (PR) technique have not been reported. The purpose of this study was to use PR measurement technique to compare the differences in spinopelvic sagittal alignment between DS and LSS. METHODS: A total of 145 patients with DS or LSS were retrospectively reviewed...
July 25, 2018: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
Permsak Paholpak, Alexander Nazareth, Yusuf A Khan, Sameer U Khan, Faisal Ansari, Koji Tamai, Zorica Buser, Jeffrey C Wang
PURPOSE: To evaluate the kinematic change of cross-sectional area of lumbar intervertebral foramen in degenerative lumbar spondylolisthesis patients using multi-positional MRI. METHODS: Multi-positional MRI was performed on 31 patients diagnosed with single or multilevel degenerative lumbar spondylolisthesis and 31 control patients without degenerative lumbar spondylolisthesis. Foraminal area (FA) was measured at the lumbar spondylolisthesis level in degenerative lumbar spondylolisthesis group and at L3-4, L4-5, and L5-S1 level in the control group...
July 27, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Chi Heon Kim, Chun Kee Chung, Myo Jeong Kim, Yunhee Choi, Min-Jung Kim, Sukyoun Shin, Jong-Myung Jung, Sung Hwan Hwang, Seung Heon Yang, Sung Bae Park, Jun Ho Lee
OBJECTIVE: Examining spine surgery patterns over time is crucial to provide insights into variations and changes in clinical decision making. Changes in the number of surgeries, surgical methods, reoperation rates and cost-effectiveness were analyzed for all patients who underwent surgery for lumbar spinal stenosis without spondylolisthesis in 2003 (2003 cohort) and 2008 (2008 cohort). METHODS: The national health insurance database was used to create the 2003 cohort (n = 10,990) and 2008 cohort (n = 27,942)...
July 24, 2018: World Neurosurgery
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