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https://www.readbyqxmd.com/read/28092340/decompression-surgery-alone-versus-decompression-plus-fusion-in-symptomatic-lumbar-spinal-stenosis-a-swiss-prospective-multi-center-cohort-study-with-3-years-of-follow-up
#1
Nils H Ulrich, Jakob M Burgstaller, Giuseppe Pichierri, Maria M Wertli, Mazda Farshad, François Porchet, Johann Steurer, Ulrike Held
STUDY DESIGN: Retrospective analysis of a prospective, multicenter cohort study. OBJECTIVE: To estimate the added effect of surgical fusion as compared to decompression surgery alone in symptomatic lumbar spinal stenosis patients with spondylolisthesis. SUMMARY OF BACKGROUND DATA: The optimal surgical management of lumbar spinal stenosis patients with spondylolisthesis remains controversial. METHODS: Patients of the LSOS with confirmed DLSS and spondylolisthesis were enrolled in this study...
January 13, 2017: Spine
https://www.readbyqxmd.com/read/28090445/population-reference-range-for-developmental-lumbar-spinal-canal-size
#2
James F Griffith, Junbin Huang, Sheung-Wai Law, Fan Xiao, Jason Chi Shun Leung, Defeng Wang, Lin Shi
BACKGROUND: Considerable variability exists in normal developmental lumbar spinal canal size. This impacts the likelihood of neural compromise. Spinal canal development is complete by 17 years. As diseases incurred thereafter do not knowingly affect the developmental size of the spinal canal, it is reasonable to use a selected population undergoing abdominopelvic computed tomography (CT) examination to determine developmental lumbar spinal canal size. METHODS: Study approval was granted by the Clinical Research Ethics Committee...
December 2016: Quantitative Imaging in Medicine and Surgery
https://www.readbyqxmd.com/read/28087395/lumbar-spinal-muscles-and-spinal-canal-study-by-mri-three-dimensional-reconstruction-in-adult-lumbar-spinal-stenosis
#3
Louis Boissière, Bertrand Moal, Olivier Gille, Elise De-Roquefeuil, Muriel Durieux, Ibrahim Obeid, Vincent Dousset, Jean-Marc Vital, Wafa Skalli
BACKGROUND: Lumbar spinal stenosis is degenerative disc disease most common manifestation. If stenosis degree seems poorly related to symptom severity, lumbar muscles role is recognized. Many studies report imaging methods, to analyze muscle volumes and fat infiltration (FI), but remain limited due to the difficulty to represent entire muscle volume variability. Recently a 3D muscle reconstruction protocol (using the deformation of a parametric specific object method (DPSO) and three point Dixon images) was reported...
January 10, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28074438/is-there-variation-in-procedural-utilization-for-lumbar-spine-disorders-between-a-fee-for-service-and-salaried-healthcare-system
#4
Andrew J Schoenfeld, Heeren Makanji, Wei Jiang, Tracey Koehlmoos, Christopher M Bono, Adil H Haider
BACKGROUND: Whether compensation for professional services drives the use of those services is an important question that has not been answered in a robust manner. Specifically, there is a growing concern that spine care practitioners may preferentially choose more costly or invasive procedures in a fee-for-service system, irrespective of the underlying lumbar disorder being treated. QUESTIONS/PURPOSES: (1) Were proportions of interbody fusions higher in the fee-for-service setting as opposed to the salaried Department of Defense setting? (2) Were the odds of interbody fusion increased in a fee-for-service setting after controlling for indications for surgery? METHODS: Patients surgically treated for lumbar disc herniation, spinal stenosis, and spondylolisthesis (2006-2014) were identified...
January 10, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28072709/tranexamic-acid-reduces-perioperative-blood-loss-of-posterior-lumbar-surgery-for-stenosis-or-spondylolisthesis-a-randomized-trial
#5
Houyin Shi, Yunsheng Ou, Dianming Jiang, Zhengxue Quan, Zenghui Zhao, Yong Zhu
BACKGROUND: A prospective, randomized, double-blind, placebo-controlled study was performed. The routine usage of TA in spinal surgery is controversial. Only a few studies have focused on patients undergoing posterior lumbar surgery for stenosis or spondylolisthesis, although a large clinical cohort exists in the population. This study aimed to evaluate the effect and safety of TA in reducing perioperative blood loss in posterior lumbar surgery for stenosis or spondylolisthesis. METHODS: 100 eligible patients out of 126 were randomized to receive either a bolus dose of 30 mg/kg TA i...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28068753/retrospective-matched-pair-cohort-study-on-effect-of-bisegmental-fenestration-versus-hemilaminectomy-for-bisegmental-spinal-canal-stenosis-at-l3-l4-and-l4-l5
#6
Julia Schüppel, Friedrich Weber
Background The main symptoms of degenerative lumbar spinal canal stenosis are progressive back pain, spinal claudication, and, occasionally, sensory and motor deficits. Impairments particularly occur during walking, standing, and sitting. Thus social and vocational activities are increasingly restricted, causing considerable suffering for patients. Surgical therapies are superior to conservative ones. This article studies the outcome of 2-level fenestration versus hemilaminectomy for bisegmental spinal stenosis decompression...
January 9, 2017: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/28060908/experimental-mouse-model-of-lumbar-ligamentum-flavum-hypertrophy
#7
Takeyuki Saito, Kazuya Yokota, Kazu Kobayakawa, Masamitsu Hara, Kensuke Kubota, Katsumi Harimaya, Kenichi Kawaguchi, Mitsumasa Hayashida, Yoshihiro Matsumoto, Toshio Doi, Keiichiro Shiba, Yasuharu Nakashima, Seiji Okada
Lumbar spinal canal stenosis (LSCS) is one of the most common spinal disorders in elderly people, with the number of LSCS patients increasing due to the aging of the population. The ligamentum flavum (LF) is a spinal ligament located in the interior of the vertebral canal, and hypertrophy of the LF, which causes the direct compression of the nerve roots and/or cauda equine, is a major cause of LSCS. Although there have been previous studies on LF hypertrophy, its pathomechanism remains unclear. The purpose of this study is to establish a relevant mouse model of LF hypertrophy and to examine disease-related factors...
2017: PloS One
https://www.readbyqxmd.com/read/28059949/the-influence-of-single-level-versus-multilevel-decompression-on-the-outcome-in-multisegmental-lumbar-spinal-stenosis-analysis-of-the-lumbar-spinal-outcome-study-lsos-data
#8
Nils H Ulrich, Jakob M Burgstaller, Ulrike Held, Sebastian Winklhofer, Mazda Farshad, Giuseppe Pichierri, Johann Steurer, François Porchet
STUDY DESIGN: This is prospective multicenter cohort study. OBJECTIVE: To assess whether patients with confirmed multisegmental lumbar spinal stenosis benefit more from a single-level or a multilevel decompression. SUMMARY OF BACKGROUND DATA: In multisegmental lumbar spinal stenotic cases, the decision as to how many levels of stenosis need to be operated to achieve the best possible clinical outcome is still unknown and remains a controversy between spine surgeons...
January 4, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28052066/effects-of-strontium-ranelate-on-spinal-interbody-fusion-surgery-in-an-osteoporotic-rat-model
#9
Tsung-Ting Tsai, Ching-Lung Tai, Natalie Yi-Ju Ho, Po-Liang Lai, Tsai-Sheng Fu, Chi-Chien Niu, Lih-Huei Chen, Wen-Jer Chen
Osteoporosis is a bone disease that afflicts millions of people around the world, and a variety of spinal integrity issues, such as degenerative spinal stenosis and spondylolisthesis, are frequently concomitant with osteoporosis and are sometimes treated with spinal interbody fusion surgery. Previous studies have demonstrated the efficacy of strontium ranelate (SrR) treatment of osteoporosis in improving bone strength, promoting bone remodeling, and reducing the risk of fractures, but its effects on interbody fusion surgery have not been adequately investigated...
2017: PloS One
https://www.readbyqxmd.com/read/28043848/surgical-treatment-of-degenerative-spondylolisthesis
#10
REVIEW
P Guigui, E Ferrero
Degenerative spondylolisthesis is a common pathology, often causing lumbar canal stenosis. There is, however, no strong consensus regarding the various medical and surgical treatments available. Surgery is indicated mainly for perceived functional impairment; when the indication is accepted, several questions determine the choice of surgical strategy. Improvement in neurological symptoms is one of the main treatment objectives. For this, it is useful to perform radicular decompression. Some authors recommend indirect decompression by interbody fusion (ALIF, TLIF, XLIF), others by means of an interspinous spacer but the most frequent technique is direct posterior decompression...
December 30, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28042118/post-operative-neuropathy-after-total-hip-arthroplasty
#11
E P Su
Nerve palsy is a well-described complication following total hip arthroplasty, but is highly distressing and disabling. A nerve palsy may cause difficulty with the post-operative rehabilitation, and overall mobility of the patient. Nerve palsy may result from compression and tension to the affected nerve(s) during the course of the operation via surgical manipulation and retractor placement, tension from limb lengthening or compression from post-operative hematoma. In the literature, hip dysplasia, lengthening of the leg, the use of an uncemented femoral component, and female gender are associated with a greater risk of nerve palsy...
January 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28040872/cost-effectiveness-of-conservative-versus-surgical-treatment-strategies-of-lumbar-spinal-stenosis-in-the-swiss-setting-analysis-of-the-prospective-multicenter-lumbar-stenosis-outcome-study-lsos
#12
A Aichmair, J M Burgstaller, M Schwenkglenks, J Steurer, F Porchet, F Brunner, M Farshad
PURPOSE: To evaluate the cost-effectiveness of conservative versus surgical treatment strategies for lumbar spinal stenosis (LSS). METHODS: Patients prospectively enrolled in the multicenter Lumbar Stenosis Outcome Study (LSOS) with a minimum follow-up of 12 months were included. Quality adjusted life years (QALY) were calculated based on EQ-5D data. Cost data were retrieved retrospectively. Cost-effectiveness was calculated via decision tree analysis. RESULTS: A total of 434 patients were included, treated surgically (n = 170) or conservatively (n = 264) for LSS...
December 31, 2016: European Spine Journal
https://www.readbyqxmd.com/read/28027828/prognosis-and-adjacent-segment-disease-after-lumbar-spinal-fusion-surgery-for-destructive-spondyloarthropathy-in-long-term-hemodialysis-patients
#13
Keishi Maruo, Tokuhide Moriyama, Toshiya Tachibana, Shinichi Inoue, Fumihiro Arizumi, Kazuki Kusuyama, Shinichi Yoshiya
BACKGROUND: Lumbar destructive spondyloarthropathy (DSA) is a serious complication in long-term hemodialysis patients. There have not been many reports regarding the surgical management for lumbar DSA. In addition, the adjacent segment pathology after lumbar fusion surgery for DSA is unclear. The objective of this study was to assess the clinical outcome and occurrence of adjacent segmental disease (ASD) after lumbar instrumented fusion surgery for DSA in long-term hemodialysis patients...
December 24, 2016: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/28026727/radiological-changes-after-interspinous-dynamic-stabilisation-for-lateral-stenosis-of-lumbar-spinal-canal-a-parallel-group-randomised-trial
#14
J Mohar, M Cimerman
PURPOSE OF THE STUDY Interspinous dynamic stabilisation devices (IDSDs) are used for stabilisation and indirect decompression of the spinal motion segment in minimally invasive treatment of degenerative conditions of lumbar spine. Good methodological quality studies on biomechanical effects of IDSDs are lacking in scientific literature. The purpose of this study was to evaluate the biomechanical effect of dynamic IDSD implantation on a spinal motion segment. MATERIAL AND METHODS We conducted a parallel group randomised trial (RT) on twelve patients, comparing radiological stabilisation and indirect decompression outcome measures between groups of patients with an isolated degenerative condition of L4-L5 motion segment and unilateral L5 nerve root radiculopathy...
2016: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
https://www.readbyqxmd.com/read/28025354/the-effectiveness-and-risks-of-non-image-guided-lumbar-interlaminar-epidural-steroid-injections-a-systematic-review-with-comprehensive-analysis-of-the-published-data
#15
REVIEW
Yakov Vorobeychik, Anil Sharma, Clark C Smith, David C Miller, Milan P Stojanovic, Steve M Lobel, Marc A Valley, Belinda Duszynski, David J Kennedy
OBJECTIVE: To determine the effectiveness and risks of non-image-guided lumbar interlaminar epidural steroid injections. DESIGN: Systematic review. INTERVENTIONS: Three reviewers with formal training and certification in evidence-based medicine searched the literature on non-image-guided lumbar interlaminar epidural steroid injections. A larger team of seven reviewers independently assessed the methodology of studies found and appraised the quality of the evidence presented...
December 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28025353/imaging-determinants-of-clinical-effectiveness-of-lumbar-transforaminal-epidural-steroid-injections
#16
Timothy P Maus, Christine A El-Yahchouchi, Jennifer R Geske, Rickey E Carter, Timothy J Kaufmann, John T Wald, Felix E Diehn
OBJECTIVE: To examine associations between imaging characteristics of compressive lesions and patient outcomes after lumbar transforaminal epidural steroid injections (TFESIs) stratified by steroid formulation (solution versus suspension). DESIGN/SUBJECTS: Retrospective observational study, academic radiology practice. A 516-patient sample was selected from 2,634 consecutive patients receiving lumbar TFESI for radicular pain. METHODS: The advanced imaging study(s) preceding sampled TFESI were reviewed...
December 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28009224/mesenteric-ischemia-following-the-correction-of-adult-spinal-deformity-case-report
#17
Krishn Khanna, Sigurd H Berven
Vascular complications are an important adverse event that can be associated with spinal reconstructive surgery. Direct injury of vessels, or indirect traction or compression of vessels, can cause both arterial and venous injury. Indirect compression of the mesenteric vessels is a well-recognized complication of bracing and surgical care of children with spinal deformity (superior mesenteric artery syndrome), but the complication is not common or well recognized in the adult population with spinal deformity...
December 23, 2016: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28005161/-epidural-anesthesia-for-fetoscopy-retrospective-analysis-of-a%C3%A2-one-year-cohort
#18
N Kiefer, S F Suter, C Berg, U Gembruch, S U Weber
BACKGROUND: The introduction of routine prenatal screening using ultrasound has led to a substantial increase in diagnoses of fetal disorders that are amenable to intrauterine treatment. While an ultrasound guided insertion of small bore cannulas can be performed under local anesthesia, insertion of a fetoscope usually requires anesthetic management for the mother and the fetus. Additionally, the fetus' intrauterine position may have to be manipulated in order to enable access. Such manoeuvres depend on relaxation of the mother's abdominal wall...
December 22, 2016: Der Anaesthesist
https://www.readbyqxmd.com/read/27994791/analysis-of-the-relationship-between-ligamentum-flavum-thickening-and-lumbar-segmental-instability-disc-degeneration-and-facet-joint-osteoarthritis-in-lumbar-spinal-stenosis
#19
Toyomi Yoshiiwa, Masashi Miyazaki, Naoki Notani, Toshinobu Ishihara, Masanori Kawano, Hiroshi Tsumura
STUDY DESIGN: Cross-sectional study. PURPOSE: To investigate the relationship between ligamentum flavum (LF) thickening and lumbar segmental instability and disc degeneration and facet joint osteoarthritis. OVERVIEW OF LITERATURE: Posterior spinal structures, including LF thickness, play a major role in lumbar spinal canal stenosis pathogenesis. The cause of LF thickening is multifactorial and includes activity level, age, and mechanical stress...
December 2016: Asian Spine Journal
https://www.readbyqxmd.com/read/27994789/correlation-of-1-5-tesla-magnetic-resonance-imaging-with-clinical-and-intraoperative-findings-for-lumbar-disc-herniation
#20
Shumayou Dutta, Arvind Bhave, Sanjay Patil
STUDY DESIGN: A single-center prospective study. PURPOSE: A magnetic resonance imaging (MRI) scan is undeniably the gold standard for the diagnosis of a lumbar disc prolapse. Unfortunately it shares a strong association with incidental findings. In this study, we aimed to determine the extent to which a 1.5 Tesla MRI correlates with the clinical features and intraoperative findings in cases of lumbar disc prolapse. OVERVIEW OF LITERATURE: Few studies have correlated MRI with clinical findings, and none have extended this correlation to intraoperative findings...
December 2016: Asian Spine Journal
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