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Lumbar And Stenosis

Chi-An Luo, Arun-Kumar Kaliya-Perumal, Meng-Ling Lu, Lih-Huei Chen, Wen-Jer Chen, Chi-Chien Niu
PURPOSE: Tandem spinal stenosis (TSS) refers to lumbar and cervical spinal canal stenosis. Staged surgery is often chosen, but sometimes, mere decompression of one stenosis is adequate to relieve symptoms. Therefore, we intend to analyze whether starting with the cervical or the lumbar region is the most logical option. METHODS: We retrospectively reviewed the data of 47 patients with TSS, having first-stage decompression for the most symptomatic stenosis, and classified into two groups (Group A: lumbar decompression first, Group B: cervical decompression first)...
October 17, 2018: European Spine Journal
Ryan K Dahlberg, Mary Elizabeth Lyvers, Thomas K Dahlberg
Salmonella vertebral discitis/osteomyelitis is a rare manifestation of Salmonella infection. Here, we report a case of a 54-year-old Caucasian male who presented with five weeks of progressively worsening bilateral low back, buttock, and lower extremity pain following an 8-foot fall onto concrete from a ladder. Initial workup following the fall included hip X-ray and MRI of the lumbar spine and revealed only mild lumbar facet arthropathy and moderate left neural foraminal stenosis at L3-L4 without any concomitant hip or spine fracture...
2018: Case Reports in Orthopedics
Camilla Bergh, Ann-Charlott Söderpalm, Helena Brisby
BACKGROUND: Osteoporosis implies an increased risk of complications after orthopedic surgery. For the mostly elderly group of patients undergoing lumbar spinal stenosis surgery (LSS), it is important to include skeletal health evaluation in the preoperative planning. The aim of this study was to assess spine and femoral neck (FN) bone mineral density (BMD) in LSS patients and to evaluate whether the World Health Organization (WHO) fracture risk assessment tool (FRAX) can identify patients with reduced BMD levels in the spine...
October 16, 2018: Journal of Orthopaedic Surgery and Research
Wataru Kuwahara, Hiroshi Kurumadani, Nobuhiro Tanaka, Kazuyoshi Nakanishi, Haruka Nakamura, Yosuke Ishii, Akio Ueda, Masataka Deie, Nobuo Adachi, Toru Sunagawa
BACKGROUND: Lumbar alignment of posterior or anterior tilts affects the exacerbation and remission of symptoms of lumbar spinal stenosis patients. This study aimed to clarify the correlation between spinal and pelvic movements during gait and the aggravation of low back pain after gait loading in lumbar spinal stenosis patients. METHODS: A total of 29 patients with lumbar spinal stenosis completed leg and low back pain assessments and gait analysis before and after gait loading tests...
October 12, 2018: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
Ashok Pedabelle Reddy, Rajat Mahajan, Tarush Rustagi, Harvinder Singh Chhabra
Study Design: Retrospective case series. Purpose: Cauda equina syndrome (CES) is associated with etiologies such as lumbar disc herniation (LDH) and lumbar canal stenosis (LCS). CES has a prevalence of 2% among patients with LDH and exhibits variable outcomes, even with early surgery. Few studies have explored the factors influencing the prognosis in terms of bladder function. Therefore, we aimed to assess the factors contributing to bladder recovery and propose a simplified bladder recovery classification...
October 16, 2018: Asian Spine Journal
Parisa Azimi, Taravat Yazdanian, Sohrab Shahzadi, Edward C Benzel, Shirzad Azhari, Hossein Nayeb Aghaei, Ali Montazeri
Study Design: Case-control. Purpose: To determine optimal cut-off value for body mass index (BMI) in predicting surgical success in patients with lumbar spinal canal stenosis (LSCS). Overview of Literature: BMI is an essential variable in the assessment of patients with LSCS. Methods: We conducted a prospective study with obese and non-obese LSCS surgical patients and analyzed data on age, sex, duration of symptoms, walking distance, morphologic grade of stenosis, BMI, postoperative complications, and functional disability...
October 16, 2018: Asian Spine Journal
Jose Ramirez-Villaescusa, Jesús López-Torres Hidalgo, Antonio Martin-Benlloch, David Ruiz-Picazo, Francisco Gomar-Sancho
OBJECT: Adjacent segment disease (ASD) has been described as a frequent complication after a lumbar spinal fusion procedure, though its incidence and the factors related to its appearance are not well established. The radiographic signs that identify ASD in unfused segments may be a consequence of biomechanical changes induced by the fusion procedure. This study sought to analyse the incidence of radiographic changes (radiographic ASD) in all adjacent unfused segments, the clinical changes that require a second procedure (clinical ASD), and the risk factors of their appearance evaluated at different follow-up times...
October 13, 2018: British Journal of Neurosurgery
Bon Sung Koo, Woo Bin Kang, Jun Woo Park, So Jeong Lee, Mi Soon Lee, A Na Cho, Yang Hoon Chung, Joon Ho Lee, Yong Ik Kim, Won Seok Chae
A caudal epidural block involves placing a needle through the sacral hiatus and delivering medication into the epidural space. The procedure is safe and simple, but failure rates can be as high as 25%. The purpose of this study was to investigate the success rate of caudal epidural block by analyzing needle placement and dye flow pattern.We retrospectively analyzed the medical records of patients who underwent caudal epidural block under spinal stenosis. A case was defined as a failure if it met at least one of the following four criteria: the epidural needle was not placed correctly inside the caudal canal; blood regurgitation or aspiration in the needle was observed; the contrast dye was injected into a blood vessel; or a large amount of the dye leaked into the sacral foramen or did not reach the L5-S1 level...
October 2018: Medicine (Baltimore)
Dong-Kyun Seo, Sookyung Lee, Gunn Lee, Myung-Su Lee, Syn-Hae Yoon, Seong-Soo Choi, Jin-Woo Shin
A previous study showed that transforaminal balloon adhesiolysis via the safe triangle was effective in lumbar spinal stenosis. However, retrodiscal pathology is difficult to treat with this method. Therefore we attempted retrodiscal balloon adhesiolysis via Kambin's triangle. The design of our study is a retrospective analysis. The setting of our study is a tertiary, interventional pain management practice, speciality referral center.The primary indication for this procedure is radicular pain arising from ipsilateral retrodiscal pathology...
October 2018: Medicine (Baltimore)
Andrée-Anne Marchand, Charles Tétreau, Julie OʼShaughnessy, Martin Descarreaux
STUDY DESIGN: Observational prospective study. OBJECTIVE: The study objective was to assess the reliability and validity of the French-Canadian version (FCSSSQ) of the Swiss Spinal Stenosis questionnaire (SSSQ). SUMMARY OF BACKGROUND DATA: The SSSQ is a validated disease-specific tool developed to assess pain, function and satisfaction with care in patients with lumbar spinal stenosis (LSS). METHODS: The French-Canadian translation and adaptation of the SSSQ was completed following a 4-stage approach: (1) forward translation; (2) synthesis; (3) expert committee review; and (4) testing of the questionnaire prefinal version...
October 11, 2018: Spine
Juan M Vinas-Rios, Fatima Medina-Govea, Viktor von Beeg-Moreno, Frerk Meyer
BACKGROUND: Risk factors for incidental durotomies are good documented claimed from some authors the degree of invasiveness as a direct risk factor on this serious complication. We compared the rate of incidental durotomies and its dependence from the degree of invasiveness. METHODS: The German Spine Registry could document 6016 surgeries for lumbar spinal canal stenosis, n= 2539 microsurgical decompression and n= 2371 open decompression with stabilization. RESULTS: Both groups were identical concerning age and sex of patients: mean age 77,1 ± 1,60, female 58%, male 32%...
October 10, 2018: Journal of Neurosurgical Sciences
Xiaozhi Qi, Yu Sun, Xiaohang Ma, Ying Hu, Jianwei Zhang, Wei Tian
The lumbar spinal stenosis (LSS) is a kind of orthopedic disease which causes a series of neurological symptom. Vertebral lamina grinding operation is a key procedure in decompressive laminectomy for LSS treatment. With the help of image-guided navigation system, the robot-assisted technology is applied to reduce the burdens on surgeon and improve the accuracy of the operation. This paper proposes a multilevel fuzzy control based on force information in the robot-assisted decompressive laminectomy to improve the quality and the robotic dynamic performance in surgical operation...
2018: Advances in Experimental Medicine and Biology
Nobuyuki Fujita, Takehiro Michikawa, Mitsuru Yagi, Satoshi Suzuki, Osahiko Tsuji, Narihito Nagoshi, Eijiro Okada, Takashi Tsuji, Masaya Nakamura, Morio Matsumoto, Kota Watanabe
PURPOSE: Potential associations between radiographic parameters and the incidence of symptomatic postoperative spinal epidural hematoma (PSEH) have not been identified. This study aimed to identify risk factors including radiographic parameters for symptomatic PSEH after posterior decompression surgery for lumbar spinal canal stenosis (LSS). METHODS: We retrospectively reviewed 1007 consecutive patients who underwent lumbar decompression surgery for lumbar spinal canal stenosis (LSS) at our institution...
October 9, 2018: European Spine Journal
Keith M Silcox, Clinton J Daniels, Glenn A Bub, Pamela J Wakefield, James D Toombs
Background: Spinal epidural lipomatosis is an uncommon source of neurogenic claudication. We present two cases of spinal epidural lipomatosis as it relates to diagnosis, management, and a possible association with common medical intervention. Case presentation: Case 1: 63-year old male patient presented with neurogenic claudication symptoms, but without evidence of bony central canal stenosis on lumbar computed tomography. He entered a trial of spinal manipulation with transient beneficial gains after seven appointments, but no durable change in neurogenic claudication...
2018: Chiropractic & Manual Therapies
Małgorzata Piechota, Robert Król, David A Elias, Wojciech Wawrzynek, Andrzej Lekstan
Background The nerve root sedimentation sign is a magnetic resonance (MR) sign, shown to be present in central lumbar spinal stenosis. The lack of sedimentation of the nerve roots to the dorsal part of the dural sac is consistent with the positive nerve root sedimentation sign. Purpose To validate the reliability of the nerve root sedimentation sign in diagnosis of different grades of lumbar spinal canal stenosis. Material and Methods This study was a retrospective review of 101 consecutive MR imaging (MRI) studies obtained on patients with clinically suspected lumbar canal stenosis...
October 3, 2018: Acta Radiologica
William C Tally, H Thomas Temple, T Y Subhawong, Timothy Ganey
Background: When conservative treatments fail to alleviate the discomfort of abnormal motion, spinal fusion has been shown to provide symptomatic treatment for spinal instability, stenosis, spondylolisthesis, and symptomatic degenerative disc disease. The trend and rates of fusion over the past few years have been dramatic in the United States. Accompanying that higher incidence has been the shifting from traditional open surgery to minimally invasive techniques to reduce scar tissue formation, extent of muscle stripping, and muscle retraction which all have been shown to adversely affect outcomes...
January 2018: International Journal of Spine Surgery
Celeste Abjornson, Byung-Jo Victor Yoon, Tucker Callanan, Daniel Shein, Samuel Grinberg, Frank P Cammisa
Background: In the absence of spondylolisthesis, fusion procedures are generally not recommended. However, decompression alone often does not provide long-term clinical success of intractable leg and back pain. Decompression with interlaminar stabilization (ILS) offers a new option within the clinical continuum of care by providing a nonfusion surgical alternative. The objective of this study is to examine the sustainability of decompression with ILS and to understand the clinical success at either 1 or 2 levels as a surgical treatment for nonspondylolisthesis patients with spinal stenosis...
January 2018: International Journal of Spine Surgery
Simon Heinrich Bayerl, Malte Dinkelbach, Petra Heiden, Vincent Prinz, Tobias Finger, Peter Vajkoczy
PURPOSE: The lumbar epidural lipomatosis (LEL) is a rare disease that can cause sciatic pain syndrome or neurological deficits comparable to symptoms caused by a classical spinal canal stenosis. In severe cases surgical decompression was conducted. However, the outcome after decompressive surgery has only been investigated in small case series. In this study we compared the outcome of LEL patients after microsurgery with the outcome of patients with classical spinal stenosis (CSS). METHODS: Patients with LEL (n = 38) and patients with CSS (n = 51), who received microsurgical decompression, were followed in a prospective observational study for 3 years...
October 1, 2018: European Spine Journal
Rachel B Simon, Christina Dowe, Samuel Grinberg, Frank P Cammisa, Celeste Abjornson
Background: To alleviate the symptoms of lumbar spinal stenosis, widely accepted methods of surgical treatment include decompression alone and decompression with fusion. As an alternative to these methods, interlaminar stabilization (ILS) devices with decompression were introduced. There is a large amount of research dedicated to examining the efficacy of ILS devices in single-level procedures, but fewer studies focus on their efficacy in 2-level procedures. The purpose of this study was to compare decompression with instrumented posterolateral fusion to decompression with interlaminar stabilization in patients who require surgical treatment at 2 levels for lumbar spinal stenosis at 5 years postoperation...
August 2018: International Journal of Spine Surgery
Kai-Uwe Lewandrowski
Background: The objective of this study was to analyze readmission rates after outpatient transforaminal endoscopic decompression surgery for lumbar foraminal and lateral recess stenosis done in an ambulatory surgery center. Endoscopic lumbar spinal surgery is gaining popularity for the treatment of lumbar disc herniations. Recent advances in surgical techniques allow for percutaneous endoscopically assisted bony decompression for neurogenic claudication symptoms due to spinal stenosis...
June 2018: International Journal of Spine Surgery
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