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degenerative lumbar stenosis

Khaled M Kebaish, Benjamin D Elder, Sheng-Fu L Lo, Timothy F Witham
STUDY DESIGN: Technical report and case illustration. OBJECTIVE: To review the rationale and steps for a sublaminar decompression in the setting of adult deformity surgery and in degenerative spondylosis. SUMMARY OF BACKGROUND DATA: Several variations of lumbar laminotomy and posterior decompressions have been reported, although these are primarily in the setting of isolated lumbar stenosis, and often focus on treatment of central stenosis...
October 21, 2016: Clinical Spine Surgery
Guoxin Fan, Xinbo Wu, Shunzhi Yu, Qi Sun, Xiaofei Guan, Hailong Zhang, Xin Gu, Shisheng He
The aim of this study was to directly compare the clinical outcomes of posterior lumbar interbody fusion (PLIF) and minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) in three-level lumbar spinal stenosis. This retrospective study involved a total of 60 patients with three-level degenerative lumbar spinal stenosis who underwent MIS-TLIF or PLIF from January 2010 to February 2012. Back and leg visual analog scale (VAS), Oswestry Disability Index (ODI), and Short Form-36 (SF-36) scale were used to assess the pain, disability, and health status before surgery and postoperatively...
2016: BioMed Research International
Janan Abbas, Viviane Slon, Hila May, Nathan Peled, Israel Hershkovitz, Kamal Hamoud
BACKGROUND: The condition of paraspinal muscles is known to be associated with some variables such as age, gender, and low back pain. It is generally agreed that these muscles play an important role in the stability and functional movements of the lumbar vertebral column. Although spinal instability has been shown to play an essential role in degenerative lumbar spinal stenosis (DLSS), the role of paraspinal muscles remains elusive. The main purpose of this study was to shed light on the relationship between the condition of paraspinal muscles and symptomatic DLSS...
October 10, 2016: BMC Musculoskeletal Disorders
Edvin Zekaj, Claudia Menghetti, Christian Saleh, Alessandra Isidori, Alberto R Bona, Enrico Aimar, Domenico Servello
BACKGROUND: Intraforaminal disc herniations at the L5-S1 level are extremely surgically challenging lesions. Intracanal approaches frequently require partial or total facetectomy, which may lead to instability. Solely extraforaminal approaches may offer limited visualization of the more medial superiorly exiting and inferiorly exiting nerve roots; this approach is also more complicated at L5-S1 due to the often large L5 transverse process and the iliac wing. METHODS: Nine patients with intraforaminal L5-S1 disc herniations, foraminal stenosis, or synovial cysts underwent contralateral interlaminar approaches for lesion resection...
2016: Surgical Neurology International
Erlick A C Pereira, Mohammad Farwana, Khai S Lam
Spinal stenosis and low-grade spondylolisthesis produce symptoms of neural compression that can be treated with extreme lateral lumbar interbody fusion (XLIF) via indirect decompression. This study aimed to investigate whether the restoration of disc dimensions would relieve symptoms of radiculopathy, claudication and back pain. In this retrospective study, patients undergoing XLIF surgery for relief of radicular symptoms or degenerative disc disease were included. Radiologically proven changes were used to assess the modes of degeneration...
October 1, 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Pasquale Donnarumma, Roberto Tarantino, Lorenzo Nigro, Marika Rullo, Domenico Messina, Daniele Diacinti, Roberto Delfini
BACKGROUND: The objective of this study is to evaluate the factors influencing the outcome of back pain and disability in patients operated for lumbar stenosis without instability and deformity using two classical surgical techniques: decompression alone and decompression plus fusion. METHODS: This is a retrospective cohort study of patients who underwent lumbar surgery with standard posterior decompression or standard posterior decompression plus pedicle screw fixation for degenerative lumbar stenosis without deformity, spondylolisthesis or instability at our department from June 2010 to January 2014...
March 2016: J Spine Surg
Ralph J Mobbs, Kevin Phan, Greg Malham, Kevin Seex, Prashanth J Rao
Degenerative disc and facet joint disease of the lumbar spine is common in the ageing population, and is one of the most frequent causes of disability. Lumbar spondylosis may result in mechanical back pain, radicular and claudicant symptoms, reduced mobility and poor quality of life. Surgical interbody fusion of degenerative levels is an effective treatment option to stabilize the painful motion segment, and may provide indirect decompression of the neural elements, restore lordosis and correct deformity. The surgical options for interbody fusion of the lumbar spine include: posterior lumbar interbody fusion (PLIF), transforaminal lumbar interbody fusion (TLIF), minimally invasive transforaminal lumbar interbody fusion (MI-TLIF), oblique lumbar interbody fusion/anterior to psoas (OLIF/ATP), lateral lumbar interbody fusion (LLIF) and anterior lumbar interbody fusion (ALIF)...
December 2015: J Spine Surg
Se-Woong Chun, Hack-Jin Lee, Koong-Ho Nam, Chul-Ho Sohn, Kwang Dong Kim, Eun-Jin Jeong, Sun-Gun Chung, Keewon Kim, Dong-Joo Kim
Spinal stenosis is a common degenerative condition. However, how neurogenic claudication develops has not been clearly elucidated. Moreover, cerebrospinal fluid physiology at the lumbosacral level has not received adequate attention. This study was conducted to compare cerebrospinal fluid hydrodynamics at the lumbosacral spinal level between patients with spinal stenosis and healthy controls. Twelve subjects (4 patients and 8 healthy controls; 25-77 years old; 7 males) underwent phase-contrast magnetic resonance imaging to quantify cerebrospinal fluid dynamics...
September 24, 2016: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
Khalid Alsaleh, Derek Ho, M Patricia Rosas-Arellano, Tanya Charyk Stewart, Kevin Roger Gurr, Christopher Stewart Bailey
OBJECTIVE: To determine the reliability and dependability of magnetic resonance imaging (MRI) and computerized tomography (CT) in the assessment of lumbar spinal stenosis and correlate the qualitative assessment to both a quantitative assessment and functional outcome measures. Multiple studies have addressed the issue of CT and MRI imaging in lumbar spinal stenosis. None showed superiority of one modality. METHODS: We performed a standardized qualitative and quantitative review of CT and MRI scans of 54 patients...
September 23, 2016: European Spine Journal
Carlo Ammendolia, Pierre Côté, Y Raja Rampersaud, Danielle Southerst, Brian Budgell, Claire Bombardier, Gillian Hawker
BACKGROUND: Lumbar spinal stenosis (LSS) is a growing health problem and a leading cause of disability and loss of independence in older adults. It is usually caused by age-related degenerative narrowing of the spinal canals leading to compression and ischemia of the spinal nerves and symptoms of neurogenic claudication. Limited walking ability is the dominant functional impairment caused by LSS. Animal studies suggest increased blood flow to the spinal nerves and spinal cord with superficial paraspinal electrical stimulation...
September 2016: Journal of Chiropractic Medicine
Jen-Chung Liao, Ping-Yeh Chiu, Wen-Jer Chen, Lih-Hui Chen, Chi-Chien Niu
BACKGROUND: In Taiwan, the life expectancy of an 80-year-old man is 88.4 years and the life expectancy of an 80-year-old woman is 89.8 years. Some of these people will develop symptomatic degenerative lumbar diseases that interfere with an active lifestyle. These older surgical candidates usually ask the surgeon whether it would be safe to undergo surgery. However, there is no literature assessing the outcomes of laminectomy, fusion and posterior fixation for degenerative lumbar diseases in patients older than 80 years...
2016: BMC Musculoskeletal Disorders
Chan Hong Park, Sang Ho Lee
BACKGROUND : Spinal stenosis is characterized by narrowing of the spinal canal, with mechanical compression of spinal nerve roots. The latter may cause low back pain and/or leg pain, as well as neurogenic claudication. Epidural steroid injection is commonly used to treat patients with lumbar spinal stenosis (LSS), but percutaneous epidural adhesiolysis has been utilized when symptoms prove refractory. Our goal was to assess the relationship between improvement shown on epidurogram and subjective patient response to adhesiolysis...
September 20, 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
Alexander Antoniadis, Nils H Ulrich, Samuel Schmid, Mazda Farshad, Kan Min
INTRODUCTION: With increasing age, ubiquitous degeneration processes lead to a narrowing of the spinal canal. Degenerative lumbar spinal stenosis (DLSS) causes functional disability and is associated with back and lower extremity pain in older individuals. The goal of this study was to determine if decompression surgery can be performed safely and provide a stable benefit in our octogenarian patient population. METHODS: In this retrospective study, 121 patients over the age of 80 (mean age: 82...
September 20, 2016: British Journal of Neurosurgery
Dong Hwa Heo, Won Suh Choi, Choon-Keun Park, Jin-Sung Kim
OBJECTIVE: The purpose of this report is to describe the surgical methodology and effectiveness of minimally invasive oblique lumbar interbody fusion (OLIF) assisted by spinal endoscopy, which can treat disc herniation from the central to contralateral foramen. OLIF showed indirect decompression effects on reduction of spondylolisthesis and a foraminal widening effect on disc height restoration. METHODS: In this study, the indirect decompression effect of OLIF was augmented by direct endoscopic decompression and spinal endoscopy for removal of herniated disc materials...
September 15, 2016: World Neurosurgery
A Vázquez-Aguilar, A Torres-Gómez, P T Atlitec-Castillo, J E De León-Martínez
Spondylolisthesis is the sliding of a vertebral body with respect to the adjacent one. According to the degree of slippage it is classified into 4 Meyerding grades. Patients with spondylolisthesis who underwent surgery with lumbar instrumentation were included. They were divided into two groups based on their body mass index: obese and non-obese. The functional capacity Oswestry score was calculated preoperatively and at one year, and it was correlated with the BMI. A total of 46 patients, 26 females and 20 males, were included, from 2010 to 2013, all of them with a diagnosis of degenerative spondylolisthesis with lumbar stenosis...
January 2016: Acta Ortopédica Mexicana
Oliver P Gautschi, Nicolas R Smoll, Holger Joswig, Marco V Corniola, Karl Schaller, Gerhard Hildebrandt, Martin N Stienen
BACKGROUND: Demographic changes will lead to an increase of elderly people in our population and consecutively to a higher prevalence of patients suffering from degenerative disc disease (DDD). The goal of this study was to investigate age-related differences in pain intensity, subjective and objective functional impairment and health-related quality of life (HRQoL) in patients with lumbar DDD. METHODS: In a prospective two-center study, back and leg pain intensity (visual analogue scale (VAS)), functional impairment (Oswestry Disability Index (ODI), Roland-Morris Disability Index (RMDI)) and HRQoL (EuroQol-5D (EQ-5D), Short-Form (SF12)) were collected for consecutive patients undergoing lumbar spine surgery...
November 2016: Clinical Neurology and Neurosurgery
C Fleege, M Rickert, I Werner, M Rauschmann, M Arabmotlagh
INTRODUCTION: Determination of the extent of spinal fusion for lumbar degenerative diseases is often difficult due to minor pathologies in the adjacent segment. Although surgical intervention is required, fusion seems to be an overtreatment. Decompression alone may be not enough as this segment is affected by multiple factors such as destabilization, low grade degeneration and an unfavorable biomechanical transition next to a rigid construct. An alternative surgical treatment is a hybrid construct, consisting of fusion and implantation of an interlaminar stabilization device at the adjacent level...
September 2016: Der Orthopäde
Arjun A Dhawale, Steven Falcone, Barth A Green, Nathan H Lebwohl
The purpose of this study is to evaluate whether the vacuum phenomenon (VP) resolves after posterolateral lumbar fusion, and whether persistence of VP is indicative of failed fusion. We retrospectively reviewed patients with degenerative lumbar spinal stenosis with instability with a positive VP on preoperative computed tomography (CT) who underwent posterolateral lumbar spinal fusion. Lumbar CT and radiographs were evaluated for the presence of VP and fusion at each level. Thirty-six positive VP levels were identified on the preoperative lumbar CT at the levels in the fusion in 18 patients...
July 2016: American Journal of Orthopedics
Vincent Challier, Louis Boissiere, Ibrahim Obeid, Jean-Marc Vital, Jean-Etienne Castelain, Antoine Bénard, Nathalie Ong, Soufiane Ghailane, Vincent Pointillart, Simon Mazas, Rémi Mariey, Olivier Gille
STUDY DESIGN: .: Monocentric Open-label Randomized Controlled Trial (MRCT) OBJECTIVE..: Comparison of clinical and radiological outcomes between isolated instrumented posterior fusion (PLF) and associated instrumented posterior fusion and interbody fusion by transforaminal approach (PLF + TLIF) for patients suffering from one-level lumbar degenerative spondylolisthesis (DS) undergoing to surgery. SUMMARY OF BACKGROUND DATA: .: DS is a common cause of symptomatic lumbar stenosis...
August 19, 2016: Spine
E Kyung Shin, Chi Heon Kim, Chun Kee Chung, Yunhee Choi, Dahae Yim, Whei Jung, Sung Bae Park, Jung Hyeon Moon, Won Heo, Sung-Mi Kim
BACKGROUND CONTEXT: Lumbar spinal stenosis (LSS) is the most common lumbar degenerative disease, and sagittal imbalance is uncommon. Forward-bending posture, which is primarily caused by buckling of the ligamentum flavum, may be improved via simple decompression surgery. PURPOSE: The objectives of this study were to identify the risk factors for sagittal imbalance and to describe the outcomes of simple decompression surgery. STUDY DESIGN: This is a retrospective nested case-control study PATIENT SAMPLE: This was a retrospective study that included 83 consecutive patients (M:F=46:37; mean age, 68...
August 18, 2016: Spine Journal: Official Journal of the North American Spine Society
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