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Lumbar spinal stenosis treatment

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https://www.readbyqxmd.com/read/29447854/risk-factors-associated-complications-for-postoperative-urinary-retention-after-lumbar-surgery-for-lumbar-spinal-stenosis
#1
Joshua L Golubovsky, Haariss Ilyas, Jinxiao Chen, Joseph E Tanenbaum, Thomas E Mroz, Michael P Steinmetz
BACKGROUND CONTEXT: Postoperative Urinary Retention (POUR) is a very common post-operative complication of all surgeries (5 - 70%) that may lead to complications such as urinary tract infection (UTI), bladder over-distention, autonomic dysregulation, and increased postoperative length of stay (LOS). Within the field of spine surgery, the reported incidence of POUR is highly variable (5.6 - 38%). Lack of clear stratification of surgical level, spinal pathology, and inadequate sample size is a major limitation of available studies concerning POUR following spine surgery that may lead to inconsistency in the incidence of POUR and the ability to model its occurrence and consequences...
February 12, 2018: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29425979/percutaneous-endoscopic-laminotomy-with-flavectomy-by-uniportal-unilateral-approach-for-the-lumbar-canal-or-lateral-recess-stenosis
#2
Chul-Woo Lee, Kang-Jun Yoon, Ji-Ho Jun
OBJECTIVE: The objective of this retrospective study was to evaluate the clinical feasibility and safety of percutaneous endoscopic decompression by uniportal, unilateral approach for the lumbar canal or lateral recess stenosis. METHODS: The procedure was performed with endoscopic instruments in the same way as with conventional microscopic laminotomy and flavectomy. Clinical outcomes (VAS, ODI, modified MacNab criteria) were evaluated. Surgical outcomes including operative time, hospital stay and complications were also investigated...
February 6, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29417785/-therapeutic-progress-in-lumbar-spinal-stenosis
#3
REVIEW
Shao-Yan Shi, Yan-Sheng Huang, Ding-Jun Hao
Along with the population aging in China, patients with lumbar spinal stenosis(LSS) caused by recessive change incessantly increase. At present, there is no adequate evidence to recommend any specific nonoperative treatment for LSS, and surgery is still an effective method. The cilincal symptoms of the patients without conservative treatment got improvement after surgery, which is the strongest evidence base. Spinal instability after simple decompression promotes the development of fusion technique, and the accelerated adjacent segment degeneration and no relief in symptoms after fusion lead to dynamic fixation technology emerge as the times require...
May 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/29417772/-case-control-study-on-two-different-surgical-approaches-combined-fixation-with-lumbar-interbody-fusion-for-the-treatment-of-single-segmental-lumbar-vertebra-diseases
#4
Zhong-You Zeng, Wei-Feng Yan, Yong-Xing Song, Ke-Ya Mao, Jian-Fei Ji, Jian-Qiao Zhang, Peng Wu, Fei Pei, Guo-Hao Song, Jian-Fu Han, Wei Yu
OBJECTIVE: To discuss the advantages and disadvantages of two different surgical approaches combined fixation with lumbar interbody fusion in treating single segmental lumbar vertebra diseases. METHODS: The clinical data of 86 patients with single segmental lumbar vertebra diseases treated from June 2011 to June 2013 was retrospectively analyzed. There were 33 males and 53 females, aged from 28 to 76 years old with an average of 53.0 years. Among them, there were 39 cases of lumbar disc degeneration, 22 cases of lumbar disc herniation complicated with spinal canal stenosis, 9 cases of huge lumbar disc herniation and 16 cases of lumbar degenerative spondylolisthesis (Meyerding degree I )...
May 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/29417770/-debridement-internal-fixation-and-reconstruction-with-titanium-mesh-for-the-surgical-treatment-of-lumbar-tuberculosis-via-a-posterior-only-approach-in-adults
#5
Chao-Feng Guo, Hong-Qi Zhang, Qi-le Gao, Jin-Yang Liu, Jian-Huang Wu
OBJECTIVE: To investigate the clinical effects, indications and key techniques of debridement, internal fixation, and reconstruction with titanium mesh in lumbar tuberculosis via a posterior-only approach in adults. METHODS: The clinical data of 26 patients with monosegment lumbar tuberculosis treated with surgery from March 2012 to March 2014 was retrospectively analyzed. Among them, 15 cases were male and 11 cases were female, and patients' age ranged from 21 to 68 years old (average, 44...
May 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/29417769/-case-control-study-of-interbody-fusion-with-simple-decompression-bone-block-in-treating-degenerative-lumbar-instability-and-spinal-stenosis
#6
Fan-Zhi Meng, Qin Gao, Xing-Long Wang, Yong He
OBJECTIVE: To explore the value of the self-decompression bone block in interbody fusion. METHODS: From April 2014 to May 2015, 42 patients with degenerative lumbar instability and spinal stenosis were treated by posterior vertebral lamina decompression and pedicle nail-rod fixation and unilateral modified transforaminal lumbar interbody fusion, including 18 males and 24 females. The treatment group had 24 cases with autologous pure decompression bone block as single interbody fusion material and the control group had 18 cases with cage and autologous bone as interbody fusion material...
May 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/29408772/cervical-spine-surgery-for-tandem-spinal-stenosis-the-impact-on-low-back-pain
#7
Matthew D Alvin, Vincent J Alentado, Daniel Lubelski, Edward C Benzel, Thomas E Mroz
STUDY DESIGN: Retrospective Cohort. OBJECTIVE: Tandem spinal stenosis (TSS) can present similarly to cervical myelopathy, but often has a worse prognosis. Few studies have investigated outcomes and compared treatment approaches for patients with TSS. We sought to determine the impact of cervical spine surgery on cervical and lumbar spine symptoms in patients with symptomatic tandem spinal stenosis. PATIENTS METHODS: 84 patients with TSS were identified over 5 years...
February 2, 2018: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/29399069/effectiveness-of-dynamic-fixation-coflex-treatment-for-degenerative-lumbar-spinal-stenosis
#8
Jun-Xi Zhang, Xi-Wei Jing, Ping Cui, Xin He, Ding-Jun Hao, Shu-Jing Li
The aim of the present study was to examine the curative effect of dynamic fixation Coflex treatment for patients with degenerative lumbar spinal stenosis. In the present study, 78 patients with degenerative lumbar spinal stenosis were recruited and divided equally into the control and observation groups. The control group was treated with traditional decompression fusion and the observation group received dynamic fixation Coflex system. Surgery and hospitalization were shorter in the observation group than in the control group...
January 2018: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29395806/a-comparative-study-of-2-year-follow-up-outcomes-in-lumbar-spinal-stenosis-patients-treated-with-physical-therapy-alone-and-those-with-surgical-intervention-after-less-successful-physical-therapy
#9
Masakazu Minetama, Mamoru Kawakami, Masafumi Nakagawa, Yuyu Ishimoto, Keiji Nagata, Daisuke Fukui, Tadashi Sumiya, Tomoko Kitagawa, Takahiro Miyake, Yoshio Yamamoto, Nana Sakon, Toshiko Matsuoka, Yukihiro Nakagawa
BACKGROUND: The efficacy of physical therapy for patients with lumbar spinal stenosis (LSS) has been reported only for the short term, and few reports have compared outcomes of surgical treatment with nonsurgical treatment after physical therapy. The purpose of this study was to assess 2-year outcomes of LSS patients treated with surgery or under follow-up observation after physical therapy for 6 weeks. METHODS: Patients presenting with neurogenic claudication, radiologically-confirmed central LSS affecting both legs and refractory symptoms to pharmacotherapy of more than 3 months were enrolled...
January 29, 2018: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/29394207/systemic-effects-of-epidural-steroid-injections-for-spinal-stenosis
#10
Janna L Friedly, Bryan A Comstock, Patrick J Heagerty, Zoya Bauer, Micol S Rothman, Pradeep Suri, Ryan Hansen, Andrew L Avins, Srdjan S Nedeljkovic, David R Nerenz, Venu Akuthota, Jeffrey G Jarvik
This analysis of the Lumbar Epidural steroid injections for Spinal Stenosis (LESS) multi-center randomized controlled trial data identifies the degree of and risk factors for cortisol suppression following epidural steroid injections in older adults with spinal stenosis. 400 patients aged > 50 years with back or leg pain and central lumbar spinal stenosis completed baseline demographic and psychosocial measures. Morning serum cortisol levels were measured at baseline and 3 weeks after initial injection. Patients were randomized to receive epidural injections of either local anesthetic with corticosteroid (n = 200) or local anesthetic only (n = 200)...
January 30, 2018: Pain
https://www.readbyqxmd.com/read/29391295/is-eighty-the-new-sixty-outcomes-and-complications-after-lumbar-decompression-surgery-in-elderly-patients-over-80-years-of-age
#11
Julia Gerhardt, Stefanie Bette, Insa Janssen, Jens Gempt, Bernhard Meyer, Yu-Mi Ryang
OBJECTIVE: An increasing demographic aging of the general population results in a rising incidence of octo- and nonagenarians with spine disease. Patients over 65 years of age represent the majority of patients with degenerative lumbar spine disease in our daily clinical routine. Due to an increased rate of comorbidities indication for surgery is seen very reluctant. We therefore assessed complication rates of lumbar decompression with regard to neurological outcome, medical conditions in patients 80 years or older in a retrospective single center series...
January 29, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29382020/failed-percutaneous-kyphoplasty-in-treatment-of-stage-3-kummell-disease-a-case-report-and-literature-review
#12
Chenggui Zhang, Guodong Wang, Xiaoyang Liu, Yang Li, Jianmin Sun
RATIONALE: Albeit it is rare, the authors report a stage 3 Kummell disease case. It is diagnosed by dynamic thoracic magnetic resonance imaging (MRI). Because there is no established strategy on stage 3 Kummell disease, we performed percutaneous kyphoplasty at first, but unfortunately made a revision surgery to remove the polymethylmethacrylate (PMMA) cement after the failure of percutaneous kyphoplasty. PATIENT CONCERNS: A 73-year-old lady with severe back pain due to osteoporosis vertebral fracture was admitted to our hospital on June 23, 2016...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29372860/prospective-randomized-multicenter-study-with-2-year-follow-up-to-compare-the-performance-of-decompression-with-and-without-interlaminar-stabilization
#13
Sven Schmidt, Joerg Franke, Michael Rauschmann, Dieter Adelt, Matteo Mario Bonsanto, Steffen Sola
OBJECTIVE Surgical decompression is extremely effective in relieving pain and symptoms due to lumbar spinal stenosis (LSS). Decompression with interlaminar stabilization (D+ILS) is as effective as decompression with posterolateral fusion for stenosis, as shown in a major US FDA pivotal trial. This study reports a multicenter, randomized controlled trial in which D+ILS was compared with decompression alone (DA) for treatment of moderate to severe LSS. METHODS Under approved institutional ethics review, 230 patients (1:1 ratio) randomized to either DA or D+ILS (coflex, Paradigm Spine) were treated at 7 sites in Germany...
January 26, 2018: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/29357335/outcome-of-transforaminal-epidural-steroid-injection-according-to-the-severity-of-lumbar-foraminal-spinal-stenosis
#14
Min Cheol Chang, Dong Gyu Lee
BACKGROUND: Lumbar foraminal spinal stenosis (LFSS) is a common cause of radicular pain in the lower extremities. Transforaminal epidural steroid injection (TFESI) is being used widely for controlling radicular pain induced by LFSS. The efficacy of TFESI has been demonstrated in previous studies. However, no study has evaluated the outcome of TFESI according to the severity of LFSS. OBJECTIVE: In this study, we evaluated the outcome of TFESI in patients with chronic lumbar radicular pain due to LFSS according to the severity of LFSS by using magnetic resonance imaging (MRI)...
January 2018: Pain Physician
https://www.readbyqxmd.com/read/29357326/fusion-or-not-for-degenerative-lumbar-spinal-stenosis-a-meta-analysis-and-systematic-review
#15
Jieliang Shen, Shen Xu, Shenxi Xu, Sen Ye, Jie Hao
BACKGROUND: Degenerative lumbar spinal stenosis (DLSS) is the main cause for chronic low back pain in the elderly. When refractory to conservative treatment, symptomatic patients commonly undergo surgery. However, whether or not fusion is a relatively better surgical option still remains unclear. OBJECTIVE: The purpose of the present study was to systematically review the clinical outcomes of spinal decompression with or without spinal fusion for DLSS. STUDY DESIGN: A systematic review of the therapeutic effect for DLSS with or without fusion...
January 2018: Pain Physician
https://www.readbyqxmd.com/read/29354740/long-term-results-with-percutaneous-interspinous-process-devices-in-the-treatment-of-neurogenic-intermittent-claudication
#16
Patrick Fransen
Background: Neurogenic intermittent claudication (NIC) is the main symptom of degenerative lumbar spinal stenosis. Percutaneous interspinous process decompression devices (IPDs) have been designed as an alternative therapy to conservative treatment and to open decompressive surgery for patients suffering from NIC. Initial short-term results were encouraging. We present the long-term results of a group of patients that we followed to provide insight on long-term outcomes and effectiveness of this technique compared to other decompression methods...
December 2017: Journal of Spine Surgery (Hong Kong)
https://www.readbyqxmd.com/read/29354735/functional-outcomes-of-laminectomy-and-laminotomy-for-the-surgical-management-lumbar-spine-stenosis
#17
Mark G Williams, Ahmad M Wafai, Malcolm D Podmore
Background: This clinical descriptive study aims to establish if differences exist in functional outcomes, to include both leg and lower back pain (LBP) as well as disability, in patients undergoing laminectomy or laminotomy surgery for lumbar spinal stenosis (LSS). Methods: We conducted a single centre, prospective study of 119 patients undergoing laminectomy or laminotomy surgery for LSS, from 2006 and 2012. Clinical outcomes for back and leg pain were analyses using Oswestry Disability Index (ODI) questionnaires and visual analogue scale (VAS) scores collected preoperatively, at 6 weeks and 1 year...
December 2017: Journal of Spine Surgery (Hong Kong)
https://www.readbyqxmd.com/read/29353327/transforaminal-endoscopic-decompression-for-thoracic-spinal-stenosis-under-local-anesthesia
#18
REVIEW
Zhi-Qiang Jia, Xi-Jing He, Li-Tao Zhao, San-Qiang Li
BACKGROUND: Thoracic spinal stenosis is a common vertebral degenerative disease, and treatment remains challenging. In recent years, transforaminal endoscopic decompression has been widely used for treating lumbar degenerative diseases. However, the efficacy of this procedure for thoracic spinal stenosis has yet to be established. Herein, we report a case of thoracic spinal stenosis treated with transforaminal endoscopic decompression under local anesthesia. CASE REPORT: An 88-year-old man presented with a 1-month history of progressive paralysis and dysesthesia in the bilateral lower extremities...
January 20, 2018: European Spine Journal
https://www.readbyqxmd.com/read/29351748/a-comparative-study-of-three-conservative-treatments-in-patients-with-lumbar-spinal-stenosis-lumbar-spinal-stenosis-with-acupuncture-and-physical-therapy-study-lap-study
#19
Hiroyuki Oka, Ko Matsudaira, Yuichi Takano, Daichi Kasuya, Masaki Niiya, Juichi Tonosu, Masayoshi Fukushima, Yasushi Oshima, Tomoko Fujii, Sakae Tanaka, Hirohiko Inanami
BACKGROUND: Although the efficiency of conservative management for lumbar spinal stenosis (LSS) has been examined, different conservative management approaches have not been compared. We have performed the first comparative trial of three types of conservative management (medication with acetaminophen, exercise, and acupuncture) in Japanese patients with LSS. METHODS: Patients with L5 root radiculopathy associated with LSS who visited our hospital for surgical treatment were enrolled between December 2011 and January 2014...
January 19, 2018: BMC Complementary and Alternative Medicine
https://www.readbyqxmd.com/read/29350291/decompressive-surgery-for-lumbar-spinal-stenosis-across-the-atlantic-a-comparison-of-preoperative-mri-between-matched-cohorts-from-the-us-and-norway
#20
Amandeep Bhalla, Thomas D Cha, Clemens Weber, Ulf Nerland, Sasha Gulati, Greger L√łnne
BACKGROUND: There are no uniform guidelines regarding when to operate for Lumbar Spinal Stenosis (LSS). As we apply findings from clinical research from one population to the next, elucidating similarities or differences provides important context for the validity of extrapolating clinical outcomes. The aim of this study was to compare the morphological severity of lumbar spinal stenosis on preoperative MRI in patients undergoing decompressive surgery in Boston, USA, and Trondheim, Norway...
January 19, 2018: Acta Neurochirurgica
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