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Lumbar spinal stenosis treatment

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https://www.readbyqxmd.com/read/28110031/interspinous-process-devices-ipd-alone-versus-decompression-surgery-for-lumbar-spinal-stenosis-lss-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#1
REVIEW
Xing-Wen Zhao, Jian-Xiong Ma, Xin-Long Ma, Fei Li, Wei-Wei He, Xuan Jiang, Yin Wang, Biao Han, Bin Lu
BACKGROUND: and purpose: Interspinous process devices (IPD) were widely used for the treatment of lumbar spinal stenosis (LSS). However, whether IPD was superior to bony decompression was still debated. We aimed to compare the clinical outcomes of IPD to bony decompression for LSS. METHODS: PubMed, Cochrane library, Cochrane Central Register of Controlled Trials (CCTR), Ovid Medline, China national knowledge internet database, Wan Fang database were searched in August...
January 18, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28102171/lumbar-disc-herniation-causing-cauda-equina-syndrome-in-a-paediatric-patient-a-case-report
#2
Mohamad Irshad, Khurshid Ahmad, Hilal Ahmad Malla
Lumbar disc disease occurs mainly in the adult population. A disc prolapse in the paediatric population is very rare. Cauda equine syndrome resulting from compression of the cauda equina is a rare syndrome and is one of the few spinal surgical emergencies. Here we present a 13-year-old boy with pain in the lumbar region radiating bilaterally to the lower limbs, with asymmetrical weakness of lower the limbs, perianal hypoaesthesia and urinary retention. MRI of lumbar spine confirmed disc protrusion at the L3-L4 level with severe spinal canal stenosis...
August 30, 2016: Ortopedia, Traumatologia, Rehabilitacja
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
#3
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/28052066/effects-of-strontium-ranelate-on-spinal-interbody-fusion-surgery-in-an-osteoporotic-rat-model
#4
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
#5
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
#6
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
#7
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/28026727/radiological-changes-after-interspinous-dynamic-stabilisation-for-lateral-stenosis-of-lumbar-spinal-canal-a-parallel-group-randomised-trial
#8
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/28009224/mesenteric-ischemia-following-the-correction-of-adult-spinal-deformity-case-report
#9
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/27981454/is-the-duration-of-pre-operative-conservative-treatment-associated-with-the-clinical-outcome-following-surgical-decompression-for-lumbar-spinal-stenosis-a-study-based-on-the-spine-tango-registry
#10
Thomas Zweig, Juliane Enke, Anne F Mannion, Rolf Sobottke, Markus Melloh, Brian J C Freeman, Emin Aghayev
BACKGROUND: The incidence of lumbar spinal stenosis (LSS) continues to rise, with both conservative and surgical management representing options for its treatment. The timing of surgery for LSS varies from shortly after the onset of symptoms to several months or years after conservative treatment. The aim of this study was to investigate the association between the duration of pre-operative conservative treatment and the ultimate outcome following surgical interventions for LSS. METHODS: The study was based on prospective multicentre registry data (Spine Tango)...
December 15, 2016: European Spine Journal
https://www.readbyqxmd.com/read/27977571/percutaneous-endoscopic-transforaminal-lumbar-spinal-canal-decompression-for-lumbar-spinal-stenosis
#11
Bingtao Wen, Xifeng Zhang, Lin Zhang, Peng Huang, Guoquan Zheng
This study aimed to evaluate the safety and curative effect of percutaneous endoscopic transforaminal lumbar spinal canal decompression in the treatment of lumbar spinal stenosis.This retrospective study recruited 64 patients with lumbar spinal stenosis who underwent percutaneous endoscopic lumbar spinal canal decompression via surgical approach of posterolateral intervertebral foramen. The postoperation neurological function and pain status were evaluated by the visual analog scale (VAS) score of pain and the Oswestry disability index (ODI), and the patient satisfaction was evaluated according to the MacNab outcome criteria...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27939747/maximum-pain-on-visual-analog-scales-in-spinal-disorders
#12
Caleb J Behrend, Etienne M Schönbach, Alexander R Vaccaro, Ellen Coyne, Mark L Prasarn, Glenn R Rechtine
BACKGROUND CONTEXT: Determining pain intensity is largely dependent on the patient's report. PURPOSE: The objective of this study was to test the hypothesis that patients initially reporting a pain score of 10 out of 10 on the visual analog scale (VAS) would experience symptom improvement to a degree similar to patients reporting milder pain. STUDY DESIGN: This study is a retrospective chart review. PATIENT SAMPLE: A total of 6,779 patients seeking care for spinal disorders were included in the study...
December 6, 2016: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/27890911/suprapedicular-foraminal-endoscopic-approach-to-lumbar-lateral-recess-decompression-surgery-to-treat-degenerative-lumbar-spinal-stenosis
#13
Ya-Peng Wang, Wei Zhang, Bao-Li Li, Ya-Peng Sun, Wen-Yuan Ding, Yong Shen
BACKGROUND To discuss the strategy of suprapedicular foraminal endoscopic approach to lumbar lateral recess decompression and evaluate the safety and effectiveness of this strategy. MATERIAL AND METHODS Complete clinical information of 52 cases of lumbar lateral recess decompression with therapy of suprapedicular foraminal endoscopic approach were analyzed during the period from February 2010 to April 2014 in the Third Hospital of Hebei. All patients were followed up for 24 months, and VAS, JOA, ODI, and LRD were compared between preoperative and postoperative therapy and changes of FA...
November 28, 2016: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/27858395/low-back-pain-and-internet-infopollution
#14
Yavuz Samanci, Suat Erol Çelik
AIM: Increasing number of patients engages in health information seeking via the Internet. We aimed to determine the quality of information on Internet for treatment of three common neurosurgical conditions associated with lower back pain using the DISCERN® instrument. MATERIAL AND METHODS: The search phrases "lumbar disc herniation treatment", "lumbar spinal stenosis treatment" and "lumbar spondylolisthesis treatment" were searched in the Google® search engine using simple searching method...
October 14, 2016: Turkish Neurosurgery
https://www.readbyqxmd.com/read/27852717/efficacy-of-acupuncture-for-degenerative-lumbar-spinal-stenosis-protocol-for-a-randomised-sham-acupuncture-controlled-trial
#15
Zongshi Qin, Yulong Ding, Jiani Wu, Jing Zhou, Likun Yang, Xiaoxu Liu, Zhishun Liu
INTRODUCTION: Degenerative lumbar spinal stenosis (DLSS) is a major public health problem and the primary reason why older adults seek lumbar spine surgery. Acupuncture may be effective for DLSS, but the evidence supporting this possibility is still limited. METHODS AND ANALYSIS: A total of 80 participants with DLSS will be randomly allocated to either an acupuncture group or a sham acupuncture (SA) group at a ratio of 1:1. 24 treatments will be provided over 8 weeks...
November 16, 2016: BMJ Open
https://www.readbyqxmd.com/read/27849674/lumbar-spinal-stenosis-how-is-it-classified
#16
Gregory D Schroeder, Mark F Kurd, Alexander R Vaccaro
The prevalence of lumbar spinal stenosis is approximately 9.3%, with people most commonly affected in the sixth or seventh decade of life. Patients often have pain, cramping, and weakness in their legs that is worsened with standing and walking. Although the Spine Patient Outcomes Research Trial clearly demonstrated that surgery improves health-related quality of life, treatment for lumbar spinal stenosis varies widely from the type of decompression performed to the need for fusion. This variability can be attributed largely to the lack of an accepted classification system...
December 2016: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/27848083/surgical-management-of-lumbar-spinal-stenosis-a-survey-among-norwegian-spine-surgeons
#17
Clemens Weber, Greger Lønne, Vidar Rao, Asgeir S Jakola, Ole Solheim, Ulf Nerland, Ivar Rossvoll, Øystein P Nygaard, Wilco C Peul, Sasha Gulati
BACKGROUND: Symptomatic lumbar spinal stenosis (LSS) is the most common reason for lumbar surgery in the elderly. There is growing evidence that decompressive surgery offers an advantage over non-surgical management for selected patients with persistent severe symptoms. Based on treatment traditions, open laminectomy has been the gold standard surgical treatment, but various other surgical and non-surgical treatments for LSS are widely used in clinical practice. Therefore, we conducted a survey study to capture potential diversities in surgeons' management of LSS in Norway...
January 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/27843780/percutaneous-lumbar-decompression-with-spinejet-hydrosurgery-in-the-treatment-of-lumbar-spinal-stenosis-secondary-to-ligamentum-flavum-hypertrophy
#18
Julien Vaisman, Joe Ordia
INTRODUCTION: Lumbar spinal stenosis with symptomatic neurogenic claudication is a frequently encountered clinical entity which requires endoscopic or open spine surgery once the patients fail to respond to conservative therapies. In this case report we present a novel minimally invasive decompression technique using a fluid jet device (HydroCision Inc, Billerica, MA, USA) for a patient with symptomatic spinal stenosis secondary to ligamentum flavum hypertrophy. To our knowledge this approach has never been described in the medical literature...
August 2016: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/27843678/commentary-on-the-role-of-surgery-for-treatment-of-low-back-pain-insights-from-the-randomized-controlled-sport-trials
#19
Nancy E Epstein
BACKGROUND: The SPORT trial database offered much useful information regarding the efficacy of surgical treatment for lumbar disc herniations, lumbar spinal stenosis, and degenerative spondylolisthesis. Data were obtained from 13 sites and included 2500 patients. METHODS: The randomized trial for lumbar disc herniations was contaminated by the immense crossover of patients from surgical (50%) to non-surgical (30%) groups. Weinstein et al. concluded that they could not claim superiority of one treatment modality over the other...
2016: Surgical Neurology International
https://www.readbyqxmd.com/read/27819001/interspinous-process-decompression-expanding-treatment-options-for-lumbar-spinal-stenosis
#20
Pierce D Nunley, A Nick Shamie, Scott L Blumenthal, Douglas Orndorff, Jon E Block, Fred H Geisler
Interspinous process decompression is a minimally invasive implantation procedure employing a stand-alone interspinous spacer that functions as an extension blocker to prevent compression of neural elements without direct surgical removal of tissue adjacent to the nerves. The Superion® spacer is the only FDA approved stand-alone device available in the US. It is also the only spacer approved by the CMS to be implanted in an ambulatory surgery center. We computed the within-group effect sizes from the Superion IDE trial and compared them to results extrapolated from two randomized trials of decompressive laminectomy...
2016: BioMed Research International
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