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Lumbar spinal stenosis treatment

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https://www.readbyqxmd.com/read/29223522/custom-made-titanium-3d-printed-interbody-cages-for-treatment-of-osteoporotic-fracture-related-spinal-deformity
#1
Timothy Siu, Jeffrey M Rogers, Kainu Lin, Robert Thompson, Mark Owbridge
BACKGROUND: Advances in minimally invasive interbody fusion have greatly enhanced surgeons' capability to correct adult spinal deformity with reduced morbidity. However, the feasibility of such approaches is limited in patients with previous osteoporotic fractures as the resultant vertebral deformity renders the endplate geometry incongruous with conventional interbody implants. Current 3D printing technology offers a novel solution by fabricating custom-made implants tailored to individual anatomy...
December 6, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29201578/vertebral-compression-fractures-after-lumbar-instrumentation
#2
Michelle Granville, Aldo Berti, Robert E Jacobson
Lumbar spinal stenosis (LSS) is primarily found in an older population. This is a similar demographic group that develops both osteoporosis and vertebral compression fractures (VCF). This report reviewed a series of patients treated for VCF that had previous lumbar surgery for symptomatic spinal stenosis. Patients that only underwent laminectomy or fusion without instrumentation had a similar distribution of VCF as the non-surgical population in the mid-thoracic, or lower thoracic and upper lumbar spine. However, in the patients that had previous short-segment spinal instrumentation, fractures were found to be located more commonly in the mid-lumbar spine or sacrum adjacent to or within one or two spinal segments of the spinal instrumentation...
September 29, 2017: Curēus
https://www.readbyqxmd.com/read/29195847/trochanteric-bursitis-following-primary-total-hip-arthroplasty-incidence-predictors-and-treatment
#3
Shai S Shemesh, Calin S Moucha, Aakash Keswani, Nolan A Maher, Darwin Chen, Michael J Bronson
BACKGROUND: Trochanteric bursitis (TB) remains a common complication after total hip arthroplasty (THA), with an incidence between 3% and 17%, depending on the surgical approach, with the posterior approach (PA) being relatively protective compared to the lateral approach. The purposes of this study were to determine the incidence of TB after primary THA, identify potential risk factors for TB, and examine the utility of different modes of treatment. METHODS: Retrospective cohort data of 990 primary THAs performed in a single institution, including 613 PAs and 377 direct anterior approaches (DAAs), were analyzed...
November 13, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29191530/acute-bilateral-isolated-foot-drop-changing-the-paradigm-in-management-of-degenerative-spine-surgery-with-percutaneous-endoscopy
#4
Nitin Adsul, Hyeun Sung Kim, Sung Ho Choi, Jee-Soo Jang, Il-Tae Jang, Seong-Hoon Oh
BACKGROUND: Acute bilateral isolated foot drop due to Lumbar disc prolapse with canal stenosis is very rare with only three cases reported in literature. Our patient was managed using the percutaneous full endoscopic technique. This is mainly to highlight the ease of access and patient outcome with pre and postoperative images to support our minimally invasive treatment for this rare condition. CASE DESCRIPTION: A 46-year-old male presented with sudden onset severe back pain with bilateral foot drop...
November 27, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29175855/increasing-the-use-of-patient-decision-aids-in-orthopaedic-care-results-of-a-quality-improvement-project
#5
Mahima Mangla, Thomas D Cha, Janet M Dorrwachter, Andrew A Freiberg, Lauren J Leavitt, Harry E Rubash, Leigh H Simmons, Emily L Wendell, Karen R Sepucha
OBJECTIVE: To integrate patient decision aid (DA) delivery to promote shared decision-making and provide more patient-centred care within an orthopaedic surgery department for treatment of hip and knee osteoarthritis, lumbar herniated disc and lumbar spinal stenosis. METHODS: Different strategies were used across three distinct phases to promote DA delivery. First, we used a quality improvement bonus to generate awareness and interest in the DAs among specialists...
November 24, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/29162138/predictability-of-the-effects-of-facet-joint-infiltration-in-the-degenerate-lumbar-spine-when-assessing-mri-scans
#6
Ulf Krister Hofmann, Ramona Luise Keller, Christian Walter, Falk Mittag
BACKGROUND: Imaging results are frequently considered as hallmarks of disease by spine surgeons to plan their future treatment strategy. Numerous classification systems have been proposed to quantify or grade lumbar magnetic resonance imaging (MRI) scans and thus objectify imaging findings. The clinical impact of the measured parameters remains, however, unclear. To evaluate the pathological significance of imaging findings in patients with multisegmental degenerative findings, clinicians can perform image-guided local infiltrations to target defined areas such as the facet joints...
November 21, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/29149159/in-errata-cost-utility-analysis-of-lumbar-interlaminar-epidural-injections-in-the-treatment-of-lumbar-disc-herniation-central-spinal-stenosis-and-axial-or-discogenic-low-back-pain
#7
https://www.readbyqxmd.com/read/29149145/endoscopic-epidural-laser-decompression-versus-transforaminal-epiduroscopic-laser-annuloplasty-for-lumbar-disc-herniation-a-prospective-randomized-trial
#8
Chang Hong Park, Sang Ho Lee
BACKGROUND: Lumbar radicular pain often results from lumbar disc herniation, spinal stenosis, or degenerative spondylolisthesis. Minimally invasive disc decompression procedures, such as nucleo-annuloplasty or epiduroscopic neural decompression by laser, have been devised to treat such pain. OBJECTIVE: The short-term outcomes of disc decompression by endoscopic epidural laser decompression (EELD) or transforaminal epiduroscopic laser annuloplasty (TELA) were compared in patients with lumbar radicular pain due to disc herniation...
November 2017: Pain Physician
https://www.readbyqxmd.com/read/29137932/the-tibial-nerve-compression-test-for-the-diagnosis-of-lumbar-spinal-canal-stenosis-a-simple-and-reliable-physical-examination-for-use-by-primary-care-physicians
#9
Shu Adachi, Atsushi Nakano, Akihiro Kin, Ichiro Baba, Yoshitaka Kurokawa, Masashi Neo
OBJECTIVES: In the present study, we aimed to evaluate the diagnostic accuracy and suitability of the 'Tibial Nerve Compression Test (TNCT)' as a screening tool for lumbar spinal canal stenosis (LSS). METHODS: A total of 108 consecutive patients admitted to our hospital for surgical treatment or diagnosis of LSS were included in this study. Fifty healthy volunteers were examined as a control group. The severity of tenderness was scored (tenderness score) and measured on a visual analogue scale (P-VAS score)...
November 11, 2017: Acta Orthopaedica et Traumatologica Turcica
https://www.readbyqxmd.com/read/29137917/radiation-exposure-with-hybrid-image-guidance-based-minimally-invasive-transforaminal-lumbar-interbody-fusion
#10
Michael M Safaee, Taemin Oh, Murat Pekmezci, Aaron J Clark
The transforaminal lumbar interbody fusion (TLIF) is used for the treatment of back and leg pain secondary to spinal stenosis, degenerative disc disease, and spondylolisthesis. Minimally invasive surgery (MIS) is associated with less estimated blood loss (EBL), decreased length of stay, lower infection rates, and similar outcomes compared to the traditional TLIF. Fluoroscopy time has been reported with MIS-TLIF, but there are limited data on specific radiation dosages. We performed a retrospective analysis of a prospectively acquired cohort of patients undergoing MIS-TLIF...
November 11, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29131234/the-role-of-triangular-vertebral-canal-shape-in-surgical-management-of-patients-with-lumbar-spinal-stenosis-a-cross-sectional-study
#11
Huseyin Bozkurt, İsmail Kaya, Bilge Oztoprak
AIM: We assessed the role of triangular vertebral canal shape (VCS) in pain severity, pain-related findings, and postoperative satisfaction in patients with lumbar spinal stenosis (LSS) who had undergone decompressive surgery. MATERIAL AND METHODS: This cross-sectional study conducted at a single center included 61 consecutive patients who had undergone surgical treatment for LSS. By comparing pre- and postoperative data, the role of triangular VCS in pain severity [assessed using a visual analog scale (VAS)], pain-related findings, and postoperative satisfaction of patients was examined...
October 18, 2017: Turkish Neurosurgery
https://www.readbyqxmd.com/read/29119044/nursing-review-of-diagnosis-and-treatment-of-lumbar-degenerative-spondylolisthesis
#12
Nancy E Epstein, Renee D Hollingsworth
Background: In the lumbar spine, degenerative spondylolisthesis or degenerative (not traumatic) slippage of one vertebral body over another is divided into 4 grades - grade I (25%), grade II (50%), grade III (75%), and grade IV (100%). Dynamic X-rays, magnetic resonance (MR), and computed tomography (CT) scans document the slip secondary to arthritic changes of the facet joint plus stenosis, ossification of the yellow ligament, disc herniations, and synovial cysts. MR best demonstrates soft tissue pathology whereas CT better delineates ossific/calcified disease...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/29097954/redundant-nerve-root-in-a-patient-with-chronic-lumbar-degenerative-canal-stenosis
#13
Federico E Villafañe, Allison Harvey, Norman Kettner
Objective: The purpose of this case report is to describe the diagnostic imaging features of redundant nerve roots caused by chronic lumbar degenerative canal stenosis (CLDCS). Clinical Features: A 56-year-old male presented with severe low back pain. He experienced pain during minimal active lumbar range of motion. The patient demonstrated weakness of the right iliopsoas and hypoesthesia of the L-2 dermatome. A working diagnosis of CLDCS was established. The patient's worsening severe low back pain warranted magnetic resonance imaging of the lumbar spine, which was performed for further evaluation...
September 2017: Journal of Chiropractic Medicine
https://www.readbyqxmd.com/read/29093781/efficacy-of-the-thoracolumbar-interfascial-plane-block-for-lumbar-laminoplasty-a-retrospective-study
#14
Hironobu Ueshima, Tomoyuki Ozawa, Tomoaki Toyone, Hiroshi Otake
Study Design: This paper was a single center-based retrospective study with prospective data collection. Purpose: Compared with other surgeries, limited options are available for perioperative pain management in spinal surgery. Therefore, we aimed to identify new pain management in this study. Overview of Literature: The thoracolumbar interfascial plane (TLIP) block has been reported to provide effective regional analgesia in the lumbar region...
October 2017: Asian Spine Journal
https://www.readbyqxmd.com/read/29075539/successful-treatment-of-klebsiella-pneumoniae-harboring-a-klebsiella-pneumoniae-carbapenemase-isolated-from-lumbar-wound-infection-and-blood-in-a-patient-with-hardware-retention
#15
Alan Bulbin, Carol Bono, Tena Philp, Noriel Mariano, Carl Urban
Infections caused by carbapenem-resistant Enterobacteriaceae, especially carbapenemase producing Klebsiella pneumoniae, represent an urgent threat as outlined by the Centers for Disease Control and Prevention (CDC). We present a 66-year-old male with spinal stenosis who underwent elective L2-pelvis posterior spinal fusion at an outside institution and rapidly developed a complicated infection with Klebsiella pneumoniae harboring Klebsiella pneumoniae carbapenemase. This is the first described case of a patient with Klebsiella pneumoniae harboring Klebsiella pneumoniae carbapenemase causing postoperative lumbar wound infection and bacteremia, successfully treated with ceftazidime-avibactam in combination with additional synergistic antibacterials and without hardware removal...
2017: Case Reports in Infectious Diseases
https://www.readbyqxmd.com/read/29047242/effect-of-sagittal-balance-on-risk-of-falling-after-lateral-lumbar-interbody-fusion-surgery-combined-with-posterior-surgery
#16
Byung Ho Lee, Jae Ho Yang, Hak Sun Kim, Kyung Soo Suk, Hwan Mo Lee, Jin Oh Park, Seong Hwan Moon
PURPOSE: To demonstrate the impact of correcting sagittal balance (SB) on functional outcomes of surgical treatment for degenerative spinal disease and actual falls via utilization of new minimally invasive lumbar fusion techniques via a lateral approach. MATERIALS AND METHODS: From November 2011 to March 2015, we enrolled 56 patients who underwent minimally invasive lateral lumbar interbody fusion (LLIF) and matched 112 patients receiving decompression/postero-lateral fusion (PLF) surgery for lumbar spinal stenosis...
November 2017: Yonsei Medical Journal
https://www.readbyqxmd.com/read/29033576/lumbar-spinal-stenosis-attributable-to-tophaceous-gout-case-report-and-review-of-the-literature
#17
Wei Wang, Qingbo Li, Lei Cai, Weijun Liu
OBJECTIVES: Tophaceous gout seldom affects the axial skeleton. Symptoms vary according to the differential localization of urate deposits and the diagnosis is often delayed. Here, we report an unusual case of lumbar spinal stenosis caused by extradural tophaceous deposits. METHODS: We retrospectively reviewed a case of a patient with tophaceous gout of the lumbar spine and reviewed the relevant literature. RESULTS: A 62-year-old man with a 2-year history of lower back pain and a 3-month history of lower limb radiation pain and intermittent claudication was admitted...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/29021670/preliminary-experience-with-lumbar-facet-distraction-and-fixation-as-treatment-for-lumbar-spinal-stenosis
#18
Giovanni Grasso, Alessandro Landi
OBJECTIVES: To assess the properties of facet fixation with the Facet Wedge system in patients affected by lumbar spinal stenosis (LSS). SUMMARY OF BACKGROUND DATA: Implant of intra-articular spacers is an emerging technique for lumbar degenerative disease. METHODS: This study included forty patients (Group 1) with symptomatic LSS in whom intra-articular spacers have been implanted along with microdecompression (MD) of the neural structures...
July 2017: Journal of Craniovertebral Junction and Spine
https://www.readbyqxmd.com/read/28973638/percutaneous-interspinous-spacer-vs-decompression-in-patients-with-neurogenic-claudication-an-alternative-in-selected-patients
#19
Bernhard Meyer, Adad Baranto, Frederic Schils, Frederic Collignon, Bjorn Zoega, Leong Tan, Jean-Charles LeHuec
BACKGROUND: Standalone interspinous process devices (IPDs) to treat degenerative lumbar spinal stenosis with neurogenic intermittent claudication (NIC) have shown ambiguous results in the literature. OBJECTIVE: To show that a minimally invasive percutaneous IPD is safe and noninferior to standalone decompressive surgery (SDS) for patients with degenerative lumbar spinal stenosis with NIC. METHODS: A multicenter, international, randomized, controlled trial (RCT) was con- ducted...
June 26, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28962914/objective-measurement-of-function-following-lumbar-spinal-stenosis-decompression-reveals-improved-functional-capacity-with-stagnant-real-life-physical-activity
#20
Matthew Smuck, Amir Muaremi, Patricia Zheng, Justin Norden, Aman Sinha, Richard Hu, Christy Tomkins-Lane
BACKGROUND CONTEXT: Lumbar spinal stenosis (LSS) is a prevalent and costly condition associated with significant dysfunction. Alleviation of pain and improvement of function are the primary goals of surgical intervention. While prior studies have measured subjective improvements in function after surgery, few have examined objective markers of functional improvement. PURPOSE: We aimed to objectively measure and quantify changes in physical capacity and physical performance following surgical decompression of LSS...
September 26, 2017: Spine Journal: Official Journal of the North American Spine Society
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