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Lumbar spinal stenosis treatment

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https://www.readbyqxmd.com/read/28727709/transforaminal-percutaneous-endoscopic-discectomy-and-foraminoplasty-after-lumbar-spinal-fusion-surgery
#1
Jian-Jun Wu, Hui-Zhen Chen, Changkun Zheng
BACKGROUND: The most common causes of pain following lumbar spinal fusions are residual herniation, or foraminal fibrosis and foraminal stenosis that is ignored, untreated, or undertreated. The original surgeon may advise his patient that nothing more can be done in his opinion that the nerve was visually decompressed by the original surgery. Post-operative imaging or electrophysiological assessment may be inadequate to explain all the reasons for residual or recurrent symptoms. Treatment of failed lumbar spinal fusions by repeat traditional open revision surgery usually incorporates more extensive decompression causing increased instability and back pain...
July 2017: Pain Physician
https://www.readbyqxmd.com/read/28720994/early-migration-of-bone-graft-causing-sigmoid-colon-perforation-after-trans-foraminal-lumbar-interbody-fusion
#2
Bhavuk Garg, Amit Singla, Sahil Batra, Senthil Kumar
BACKGROUND: Tran foraminal lumbar interbody fusion (TLIF) is a well accepted and standard technique of achieving spinal fusion using pedicle screws, cage and bone graft. We are presenting here a case of L4-L5 lumbar canal stenosis managed with TLIF that presented with sigmoid colon perforation due to bone graft migration 4 days after surgery. CASE REPORT: A 35 years old female underwent open TLIF (from right side) with decompression for L4-L5 lumbar canal stenosis...
April 2017: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/28720144/identifying-predictors-for-postoperative-clinical-outcome-in-lumbar-spinal-stenosis-patients-using-smart-shoe-technology
#3
Sunghoon I Lee, Andrew Campion, Alex Huang, Eunjeong Park, Jordan H Garst, Nima Jahanforouz, Marie Espinal, Tiffany Siero, Sophie Pollack, Marwa Afridi, Meelod Daneshvar, Saif Ghias, Majid Sarrafzadeh, Daniel C Lu
BACKGROUND: Approximately 33% of the patients with lumbar spinal stenosis (LSS) who undergo surgery are not satisfied with their postoperative clinical outcomes. Therefore, identifying predictors for postoperative outcome and groups of patients who will benefit from the surgical intervention is of significant clinical benefit. However, many of the studied predictors to date suffer from subjective recall bias, lack fine digital measures, and yield poor correlation to outcomes. METHODS: This study utilized smart-shoes to capture gait parameters extracted preoperatively during a 10 m self-paced walking test, which was hypothesized to provide objective, digital measurements regarding the level of gait impairment caused by LSS symptoms, with the goal of predicting postoperative outcomes in a cohort of LSS patients who received lumbar decompression and/or fusion surgery...
July 18, 2017: Journal of Neuroengineering and Rehabilitation
https://www.readbyqxmd.com/read/28710043/minimally-invasive-computer-navigation-assisted-endoscopic-transforaminal-interbody-fusion-with-bilateral-decompression-via-a-unilateral-approach-initial-clinical-experience-at-one-year-follow-up
#4
Yaqing Zhang, Chuang Xu, Yue Zhou, Bo Huang
OBJECTIVE: The purpose of this study was to assess the feasibility of minimally invasive transforaminal lumbar interbody fusion (TLIF) and bilateral decompression via a unilateral approach that was performed with a novel working retractor with an endoscopic system for degenerative lumbar spondylolisthesis associated with spinal stenosis, to minimize surgical trauma without compromising the quality of the treatment outcome. METHODS: In this case series, the procedure was performed in 17 patients...
July 11, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28705591/effectiveness-of-surgery-versus-conservative-treatment-for-lumbar-spinal-stenosis-a-system-review-and-meta-analysis-of-randomized-controlled-trials
#5
REVIEW
Xin-Long Ma, Xing-Wen Zhao, Jian-Xiong Ma, Fei Li, Yin Wang, Bin Lu
PURPOSE: Lumbar spinal stenosis (LSS) was a common degenerative disease that affected the lumbar spine function and quality of life, which can be treated both surgery and conservative treatment. We did this study to compare the effectiveness of surgery versus conservative treatment for LSS. METHODS: We searched PubMed as well as other databases in September.18th.2016. Randomized controlled trials compared surgery versus conservative treatment for patients with LSS were enrolled...
July 10, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28696946/optimal-treatment-for-lumbar-spinal-stenosis-an-update
#6
Janus Patel, Ian Osburn, Anne Wanaselja, Ryan Nobles
PURPOSE OF REVIEW: Our review of current literature within the past 12-24 months for the treatment of lumbar spinals stenosis (LSS) serves to update providers on recent advances and comparisons regarding therapy spanning lifestyle modification, pharmacologic therapy, minimally invasive interventions, and surgical interventions. RECENT FINDINGS: Current literature supporting the inclusion of physical therapy and gabapentin/pregabalin within an initial treatment regimen have been positive...
July 10, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28691531/survival-analysis-of-the-wallis-interspinous-spacer-used-as-an-augment-to-lumbar-decompression
#7
Jamie A Nicholson, Chloe E H Scott, Andrew D Duckworth, John G Burke, John N Alastair Gibson
OBJECT: The Wallis fixed interspinous spacer may augment traditional decompression in the treatment of lumbar spinal stenosis. The aim of this study was to determine factors influencing survival of the Wallis interspinous spacer and to identify specific modes and predictors of failure. METHODS: We performed a retrospective cohort study of 244 Wallis interspinous spacers implanted in 195 consecutive patients with a mean age of 56 years (range 21-87) to augment single or multi-level decompression...
July 8, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/28690870/spinal-dural-arteriovenous-fistula-a-case-series-and-review-of-imaging-findings
#8
Shandy Fox, Luke Hnenny, Uzair Ahmed, Kotoo Meguro, Michael E Kelly
INTRODUCTION: Spinal dural arteriovenous fistulae (sdAVF) are rare lesions. Patients typically present with slowly progressive myelopathy that is often mistaken for degenerative cervical or lumbar stenosis. On spinal magnetic resonance imaging (MRI), multisegmental T2 hyperintensities along with associated flow voids are pathognomonic of sdAVF. However, diagnosis can be difficult. Definitive diagnosis and localization is achieved with complete spinal angiography. Treatment options include open surgical ligation, endovascular embolization or multimodality treatment...
2017: Spinal Cord Series and Cases
https://www.readbyqxmd.com/read/28669725/mir-21-promotes-fibrosis-and-hypertrophy-of-ligamentum-flavum-in-lumbar-spinal-canal-stenosis-by-activating-il-6-expression
#9
Chao Sun, Jiwei Tian, Xinhui Liu, Guoping Guan
The molecular mechanism underlying the fibrosis of ligamentum flavum(LF) in patients with lumbar spinal canal stenosis(LSCS) remains unknown. MicroRNAs are reported to play important roles in regulating fibrosis in different organs. The present study aimed to identify fibrosis related miR-21 expression profile and investigate the pathological process of miR-21 in the fibrosis of LF hypertrophy and associated regulatory mechanisms. 15 patients with LSCS underwent surgical treatment were enrolled in this study...
June 29, 2017: Biochemical and Biophysical Research Communications
https://www.readbyqxmd.com/read/28662247/effectiveness-of-reoperations-for-adjacent-segment-disease-following-lumbar-spinal-fusion
#10
Austin Drysch, Remi M Ajiboye, Akshay Sharma, Jesse Li, Tara Reza, Dushawn Harley, Don Y Park, Sina Pourtaheri
Although several options are available to address adjacent segment disease (ASD), the most effective surgical treatment has not been determined. In addition, it is important to subdivide ASD into stenosis with or without instability to determine if a decompression alone vs an extension of fusion is necessary. A systematic search of multiple medical reference databases was conducted for studies on surgical treatment of ASD. The primary outcome measures used were radiographic and clinical success rates. Meta-analysis was completed to determine effect summary values, 95% confidence intervals, and Q statistic and I(2) values, using the random effects model for heterogeneity...
June 29, 2017: Orthopedics
https://www.readbyqxmd.com/read/28656871/is-minimally-invasive-surgery-superior-to-open-surgery-for-treatment-of-lumbar-spinal-stenosis-a-systematic-review
#11
Karen Ka Man Ng, Jason Pui Yin Cheung
PURPOSE: The purpose of this study is to review the updated evidence comparing outcomes between minimally invasive surgery (MIS) and conventional open surgery (COS) for lumbar spinal stenosis (LSS). METHODS: All randomized controlled trials (RCTs) published from January 2005 to August 2016 were identified through PubMed and MEDLINE databases. Only RCTs including patients with LSS and with direct comparison between COS and MIS were selected for analysis. The intra- and post-operative effects of different MIS and COS on patients with LSS were evaluated for any differences...
May 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28634709/incidental-durotomy-in-decompression-for-lumbar-spinal-stenosis-incidence-risk-factors-and-effect-on-outcomes-in-the-spine-tango-registry
#12
Christian Herren, Rolf Sobottke, Anne F Mannion, Thomas Zweig, Everard Munting, Philippe Otten, Tim Pigott, Jan Siewe, Emin Aghayev
PURPOSE: The three aims of this Spine Tango registry study of patients undergoing decompression for spinal stenosis were to: report the rate of dural tear (DT) stratified by treatment centre; find factors associated with an increased likelihood of incurring a DT; and compare treatment outcomes in relation to DT (none vs. repaired vs. unrepaired DT). METHODS: Multivariate logistic regression was used to assess the association between DT and patient and treatment characteristics...
June 20, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28632546/clinical-outcome-and-postoperative-ct-measurements-of-microendoscopic-decompression-for-lumbar-spinal-stenosis
#13
Xu Zhou, Lei Zhang, Hai-Long Zhang, Shi-Sheng He, Xin Gu, Guang-Fei Gu, Qing-Song Fu
STUDY DESIGN: This was a retrospective case series. OBJECTIVE: To retrospectively evaluate the clinical outcome of microendoscopic decompression for lumbar spinal stenosis (LSS) including an evaluation of the extent of decompression using computed tomography. SUMMARY OF BACKGROUND DATA: Microendoscopic decompression has been a widely applied procedure to treat LSS with satisfactory outcomes and comparatively fewer complications and revision...
July 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28623897/altered-somatosensory-profile-according-to-quantitative-sensory-testing-in-patients-with-degenerative-lumbar-spine-disorders-scheduled-for-surgery
#14
Yvonne Lindbäck, Hans Tropp, Paul Enthoven, Björn Gerdle, Allan Abbott, Birgitta Öberg
BACKGROUND: Somatosensory profiling in affected and non-affected body regions can strengthen our insight regarding the underlying pain mechanisms, which can be valuable in treatment decision making and to improve outcomes, in patients with degenerative lumbar spine disorders pre-surgery. The aim was to describe somatosensory profiles in patients with degenerative lumbar spine disorders, to identify the proportion with altered somatosensory profile, and to analyze demographic characteristics, self-reported function, pain, and health pre- and 3 months post-surgery...
June 17, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28604494/risk-factors-for-and-complications-after-surgical-delay-in-elective-single-level-lumbar-fusion
#15
Scott C Wagner, Joseph S Butler, Ian D Kaye, Arjun Sebastian, Patrick B Morrissey, Christopher Kepler
STUDY DESIGN: Retrospective cohort Objective: To assess the incidence of and risk factors for delay of elective lumbar fusion surgery, as well as medical and surgical complications associated with surgical delay. SUMMARY OF BACKGROUND DATA: Lumbar fusion is a well-established treatment for patients with degenerative spondylolisthesis with stenosis who have failed conservative management. Rarely, patients admitted for elective lumbar fusion may experience a delay in surgery past the day of admission...
June 9, 2017: Spine
https://www.readbyqxmd.com/read/28604486/indication-variability-in-degenerative-lumbar-spine-surgery-a-4-nation-survey
#16
Bertrand Debono, Guillaume Lonjon, Luis Alvarez Galovich, Sébastien Kerever, Ben Guiot, Sven-Oliver Eicker, Olivier Hamel, Florian Ringel
STUDY DESIGN: Electronic survey OBJECTIVE.: To identify the international nuances in surgical treatment patterns for severals lumbar degenerative conditions. Specifically, identify 1) Differences in responses in each country group; 2) Identify different treatment trends across countries SUMMARY OF BACKGROUND DATA.: Significant variations in treatment of lumbar degenerative conditions exist among spine surgeons, related to the lack of established consensus in the literature. METHODS: An online survey with preformulated answers was submitted to 52 orthopaedic surgeons, 50 neurosurgeons neurosurgeons from 4 different countries (USA, France, Spain and Germany) regarding 5 vignette-cases...
June 9, 2017: Spine
https://www.readbyqxmd.com/read/28600006/is-there-still-a-role-for-interspinous-spacers-in-the-management-of-neurogenic-claudication
#17
REVIEW
Vijay M Ravindra, Zoher Ghogawala
Lumbar spinal stenosis with neurogenic claudication is prevalent in the elderly population. Decompression for this condition is the operation most commonly used to treat older patients. Because of the risks associated with open decompression procedures, particularly in older patients with comorbidities, minimally invasive procedures with implantation of interspinous process devices have been developed. This article reviews the current role of interspinous spacers in the treatment of lumbar spinal stenosis with neurogenic claudication and discusses the body of literature surrounding this treatment alternative...
July 2017: Neurosurgery Clinics of North America
https://www.readbyqxmd.com/read/28597302/the-impact-of-hypertension-on-the-occurrence-of-postoperative-spinal-epidural-hematoma-following-single-level-microscopic-posterior-lumbar-decompression-surgery-in-a-single-institute
#18
Yasushi Fujiwara, Hideki Manabe, Bunichiro Izumi, Takahiro Harada, Kazuyoshi Nakanishi, Nobuhiro Tanaka, Nobuo Adachi
PURPOSE: Postoperative spinal epidural hematoma (PSEH) is one of the most hazardous complications after spine surgery. A recent study has reported that a ≥50 mmHg increase in systolic blood pressure after extubation was a significant risk factor for symptomatic PSEH. In this paper, the impact of hypertension on PSEH occurrence was investigated. METHODS: Among a total of 2468 patients who underwent single level microscopic posterior decompression surgery for lumbar spinal stenosis in a single institute, 15 (0...
June 9, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28575297/prognostic-factors-for-satisfaction-after-decompression-surgery-for-lumbar-spinal-stenosis
#19
Rune Tendal Paulsen, Jamal Bech Bouknaitir, Søren Fruensgaard, Leah Carreon, Mikkel Andersen
BACKGROUND: Surgical treatment for lumbar spinal stenosis is associated with both short- and long-term benefits with improvements in patient function and pain. Even though most patients are satisfied postoperatively, some studies report that up to one-third of patients are dissatisfied. OBJECTIVE: To present clinical outcome data and identify prognostic factors related to patient satisfaction 1 yr after posterior decompression surgery for lumbar spinal stenosis...
June 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28547809/treatment-of-lumbar-spinal-stenosis-by-microscopic-unilateral-laminectomy-for-bilateral-decompression-a-technical-note
#20
Kevin Phan, Ian Teng, Konrad Schultz, Ralph J Mobbs
Lumbar spinal stenosis is typically a degenerative condition that leads to compression of the spinal canal and lateral recess, resulting in leg pain and walking disability. Surgical management is indicated after failure of non-surgical management or rapidly worsening neurological impairment. The traditional approach is a laminectomy with foraminotomy and partial facetectomy but a newer minimally invasive option, unilateral laminectomy for bilateral decompression (ULBD), seems to demonstrate the better postoperative outcomes due to its unilateral exposure...
May 26, 2017: Orthopaedic Surgery
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