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Augustine Balaara, Xiao-Feng Xu, Young-Hui Huang, Li Dapeng
BACKGROUND: Several surgical variables and patient characteristics play an influential role in the prognosis of lumbar disc herniation following laminotomy with discectomy. This paper seeks to evaluate the perioperative predictor variables for the outcome of lumbar disc herniation. PATIENTS AND METHODS: From October 2013 to July 2016, 166 surgical patients were evaluated using prospectively collected data. Patients' preoperative independent variables (age, sex, body mass index, level of disc herniation, pain duration, and American Society of Anesthesiologists Physical Score) were correlated with functional outcome measures such as primary outcome measures (length of hospital stay; postoperative visual analog scale, VAS; Oswestry disability index, ODI) and secondary outcome measures (operation room time; estimated intraoperative blood loss, EBL; complications; readmission) as dependent variables...
February 21, 2017: Der Orthopäde
Aniruddha Tekkatte Jagannatha, Krishna Chaitanya Joshi, Shilpa Rao, Umesh Srikantha, Ravi Gopal Varma, Anita Mahadevan
Spinal schwannomas are commonly intradural extramedullary in location. As Schwann cells are not common in the central nervous system, intramedullary schwannomas are a rare entity. In adults, an estimated sixty cases have been reported in English literature. They are rarer in children (less than ten cases), and preoperative diagnosis becomes a prerogative in achieving total excision. Cervical cord is a common location and less commonly they occur in the conus. We report a rare case of calcified conus intramedullary schwannoma in a child without neurofibromatosis, who presented with conus-cauda syndrome of 1-year duration...
October 2016: Journal of Pediatric Neurosciences
Marc D Moisi, Kimberly Hoang, R Shane Tubbs, Jeni Page, Christian Fisahn, David Paulson, Shiveindra Jeyamohan, Johnny Delashaw, David Hanscom, Rod J Oskouian, Jens Chapman
INTRODUCTION: The operative microscope has become instrumental in aiding surgeons during key microdissection with greater safety and detail. An exoscope offers similar detail with improved functionality and greater implications for live-teaching and improved operating-room flow. METHODS: Eleven senior neurosurgery residents and fellows performed unilateral, single-level laminotomies on fresh cadavers using an operating microscope and exoscope. Three attending spine surgeons blinded for the visualization technique used then reviewed and graded each decompression...
November 8, 2016: World Neurosurgery
Barrett S Boody, Jason W Savage
Lumbar facet cysts are a rare but increasingly common cause of symptomatic nerve root compression and can lead to radiculopathy, neurogenic claudication, and cauda equina syndrome. The cysts arise from the zygapophyseal joints of the lumbar spine and commonly demonstrate synovial herniation with mucinous degeneration of the facet joint capsule. Lumbar facet cysts are most common at the L4-L5 level and often are associated with spondylosis and degenerative spondylolisthesis. Advanced imaging studies have increased diagnosis of the cysts; however, optimal treatment of the cysts remains controversial...
December 2016: Journal of the American Academy of Orthopaedic Surgeons
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...
February 2017: Clinical Spine Surgery
Daniele Vanni, Renato Galzio, Anna Kazakova, Matteo Guelfi, Andrea Pantalone, Vincenzo Salini, Vincenzo Magliani
Lumbar disk herniation (LDH) is a degenerative pathology. Although LDH generally occurs without migration of the fragment to the levels above or below, in 10% of the cases, this circumstance might happen. In these cases, the standard interlaminar approach, described by Caspar cannot be performed without laminotomies, interlaminectomies, or partial or total facetectomies. The translaminar approach is the only "tissue-sparing" technique viable in cases of cranially migrated LDH encroaching on the exiting nerve root in the preforaminal zones, for the levels above L2-L3, and in the preforaminal and foraminal zones, for the levels below L3-L4 (L5-S1 included, if a total microdiscectomy is unnecessary)...
December 2015: Journal of Spine Surgery (Hong Kong)
Yashar Eshraghi, Vimal Desai, Calvin Cajigal Cajigal, Kutaiba Tabbaa
BACKGROUND: Lumbar synovial cysts can result from spondylosis of facet joints. These cysts can encroach on adjacent nerve roots, causing symptoms of radiculopathy. Currently the only definitive treatment for these symptoms is surgery, which may involve laminectomy or laminotomy, with or without spinal fusion. Surgery has been reported to successfully relieve radicular pain in 83.5% of patients by Zhenbo et al. Little information is available concerning the efficacy and outcome of percutaneous fluoroscopic synovial cyst rupture for treatment of facet joint synovial cysts...
September 2016: Pain Physician
Sangbong Ko, Seungbum Chae
STUDY DESIGN: Cross-sectional study. OBJECTIVE: To determine the correlation between SF-36 (a measure for overall health status in patients) and Oswestry-Disability Index (ODI) or Rolland-Morris Disability Questionnaire (RMDQ) confined to spine according to the type of pain from the spine. SUMMARY OF BACKGROUND DATA: Data showed moderate correlation between ODI and SF-36 Physical Component Score (PCS), Physical Functioning (PF) (r=-0.46), Physical Role Functioning (RP) (r=-0...
September 21, 2016: Clinical Spine Surgery
Kartik G Krishnan, Karsten Schöller, Eberhard Uhl
BACKGROUND: The basic necessities for surgical procedures are illumination, exposure, and magnification. These have undergone transformation in par with technology. One of the recent developments is the compact magnifying exoscope system. In this report, we describe the application of this system for surgical operations and discuss its advantages and pitfalls. METHODS: We used the ViTOM exoscope mounted on the mechanical holding arm. The following surgical procedures were conducted: lumbar and cervical spinal canal decompression (n = 5); laminotomy and removal of lumbar migrated disk herniations (n = 4); anterior cervical diskectomy and fusion (n = 1); removal of intraneural schwannomas (n = 2); removal of an acute cerebellar hemorrhage (n = 1); removal of a parafalcine atypical cerebral hematoma caused by a dural arteriovenous fistula (n = 1); and microsutures and anastomoses of a nerve (n = 1), an artery (n = 1), and veins (n = 2)...
January 2017: World Neurosurgery
Krishna Chaitanya Joshi, Kiran Khanapure, Nishchit Hegde, Niveditha Ravindra, Aniruddha T Jagannatha, Alangar S Hegde
BACKGROUND: Angiogliomas are rare low-grade glial tumors with significant vascular components. These tumors are usually seen in the brain, and spinal cord angiogliomas have not been reported in the literature until now. CASE DESCRIPTION: We report the case of a 15-year-old boy with an angioglioma of the medulla and cervicodorsal spine, which was completely excised through a combined suboccipital craniotomy and cervicodorsal laminotomy. The patient experienced excellent clinical recovery after the surgery, and follow-up contrast magnetic resonance imaging showed complete excision of the tumor...
September 15, 2016: World Neurosurgery
Woong Bae Park, Jae Taek Hong, Sang Won Lee, Jae Hoon Sung, Seung Ho Yang, Il Sub Kim
OBJECTIVE: To compare the clinical and radiological outcome of both sides using the unilateral approach. METHODS: Unilateral laminotomy was performed to achieve bilateral decompression. Thirty-nine patients who underwent this procedure were analyzed prospectively using the Oswestry Disability Index (ODI), the visual analog scale (VAS) pain score to evaluate symptoms in both legs, and the radiological morphometric index to calculate the anteriorposterior diameter and midcanal width...
June 2016: Korean Journal of Spine
Marc Moisi, Christian Fisahn, Lara Tkachenko, R Shane Tubbs, Daniel Ginat, Peter Grunert, Shiveindra Jeyamohan, Stephen Reintjes, Olaide Ajayi, Jeni Page, Rod J Oskouian, David Hanscom
Lumbar stenosis has become one of the most common spinal pathologies and one that results in neurogenic claudication, back and leg pain, and disability. The standard procedure is still an open laminectomy, which involves wide muscle retraction and extensive removal of the posterior spinal structures. This can lead to instability and the need for additional spinal fusion. We present a systemized and detailed approach to unilateral laminotomy for bilateral decompression, which we believe is superior to the standard open laminectomy in terms of intraoperative visualization, postoperative stability, and degree of invasiveness...
2016: Curēus
Marjan Alimi, Christoph P Hofstetter, Jose M Torres-Campa, Rodrigo Navarro-Ramirez, Guang-Ting Cong, Innocent Njoku, Roger Härtl
PURPOSE: Tubular laminotomy is an effective procedure for treatment of lumbar spinal stenosis (LSS) and lateral recesses stenosis. Most surgeons familiar with the procedure agree that the tubular approach appears to afford a more complete decompression of the contralateral thecal sac and nerve root, as compared to the ipsilateral approach. With this study we sought to answer the question whether this is reflected in clinically significant differences between the ipsilateral and contralateral side pain improvements...
February 2017: European Spine Journal
Erland Hermansen, Ulla Kristina Romild, Ivar Magne Austevoll, Tore Solberg, Kjersti Storheim, Jens Ivar Brox, Christian Hellum, Kari Indrekvam
INTRODUCTION: The aim of this study was to compare the clinical outcome of spinal process osteotomy with two other midline-retaining methods, bilateral laminotomy and unilateral laminotomy with crossover, among patients undergoing surgery for lumbar spinal stenosis. METHODS: This cohort study was based on data from the Norwegian Registry for Spine Surgery (NORspine). Patients were operated on between 2009 and 2013 at 31 Norwegian hospitals. The patients completed questionnaires at admission for surgery, and after 3 and 12 months...
February 2017: European Spine Journal
Shu Nakamura, Motohide Shibayama, Fujio Ito, Yasushi Miura
STUDY DESIGN: A retrospective comparative series study OBJECTIVE:: To describe a new angled chisel (NAC) that facilitates the osteotomy in Microendoscopic decompressive laminotomy (MEDL), and to analyze the clinical and radiological outcomes using the tool. SUMMARY OF BACKGROUND DATA: MEDL for lumbar spinal stenosis is a minimally invasive surgery. The paraspinous unilateral approach for bilateral decompression can preserve the posterior structure better than other methods...
June 3, 2016: Clinical Spine Surgery
Walid A Abdel Ghany, Mohamed Nada, Mahmoud A Mahran, Ahmed Aboud, Moustafa G Mahran, Marwa A A Nasef, Mohamed Gaber, Tamer Sabry, Mohamed H Ibrahim, Mohamed H Taha
BACKGROUND: Children with cerebral palsy (CP) can present with severe secondary dystonia with or without associated spasticity of their extremities. OBJECTIVE: To assess the outcomes of combined anterior and posterior lumbar rhizotomy for the treatment of mixed hypertonia in the lower extremities of children with CP. METHODS: Fifty children with CP were subjected to combined anterior and posterior lumbar rhizotomies in a prospective study...
September 2016: Neurosurgery
Gilad J Regev, Choll W Kim, Khalil Salame, Eyal Behrbalk, Ory Keynan, Ran Lador, Laurence Mangel, Zvi Lidar
STUDY DESIGN: A Prospective observational study. SUMMARY OF THE BACKGROUND DATA: Minimally invasive (MI) spine surgery techniques strive to minimize the damage to paraspinal soft tissues. Previous studies used only the length of the surgical incision to quantify the invasiveness of certain MI procedures. However, this method does not take into account the volume of muscle tissue that is dissected and retracted from the spine to achieve sufficient exposure. To date, no simple method has been reported to measure the volume of the surgical exposure and to quantify the degree of surgery invasiveness...
May 27, 2016: Clinical Spine Surgery
Soo Eon Lee, Tae-Ahn Jahng, Hyun-Jib Kim
STUDY DESIGN: Prospectively maintained and retrospectively analyzed study. OBJECTIVE: The authors have newly developed an en bloc cervical laminoplasty using translaminar screws (T-laminoplasty) to preserve the posterior midline structures so as to maintain spinal stability and prevent postoperative axial pain and deformity. SUMMARY OF BACKGROUND DATA: Cervical laminoplasty is a popular surgical procedure for patients with multilevel compressive cervical lesions...
July 2016: Clinical Spine Surgery
Yingyong Torudom, Thitinut Dilokhuttakarn
STUDY DESIGN: Retrospective. PURPOSE: To report the outcomes of patients with lumbar spinal stenosis treated with percutaneous endoscopic decompression, focusing on the results of clinical evaluations. OVERVIEW OF LITERATURE: There are no studies about two portal percutaneous endoscopic decompression in the treatment of lumbar spinal stenosis. METHODS: Medical and surgical complications were examined and clinical results were analyzed for 30 patients who consecutively underwent two portal percutaneous endoscopic decompression for lumbar spinal stenosis were reviewed...
April 2016: Asian Spine Journal
Kaveh Haddadi, Hamid Reza Ganjeh Qazvini
BACKGROUND: Laminectomy is the traditional operating method for the decompression of spinal canal stenosis. New partial decompression processes have been suggested in the treatment of lumbar stenosis. The benefit of a micro surgical approach is the chance of an extensive bilateral decompression of the spinal canal or foramen at one or numerous levels, through a minimal para-spinal muscular separation. PURPOSE: To match the safety and the clinical consequences after a bilateral laminotomy, laminectomy and trumpet laminectomy in patients with lumbar spinal stenosis who were randomized to one of three treatment groups...
2016: Frontiers in Surgery
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