Lumbar decompression

BACKGROUND: The number of interventions on intervertebral discs rapidly increased and the treatment options for lumbar disc surgery quickly evolved. It is important that the safety and efficacy of all new innovative procedures be compared with currently accepted forms of treatment; however, the previous pairwise meta-analyses could not develop the hierarchy of these treatments. OBJECTIVES: The purpose of the study is to perform a network meta-analysis to evaluate the clinical results of 7 surgical interventions for the treatment of lumbar disc herniation...

BACKGROUND: Bertolotti's syndrome is a spinal disorder characterized by abnormal enlargement of the transverse process of the most caudal lumbar vertebra. The L5 transverse process may be enlarged either unilaterally or bilaterally and may articulate or fuse with the sacrum or ilium. Pseudoarticulation between the transverse process of the L5 and the alar of the sacrum can cause buttock pain and leg pain. In addition, the L4 exiting nerve root could be compressed by an enlarged L5 transverse process...

Fractures and dislocations with complete lateral displacement of the spine at the lumbar and thoracic levels are some of the most severe types of thoracolumbar trauma. They are usually caused by high-energy trauma and accompanied by extreme, life-threatening injuries and neurological deficits that vary in severity, which may delay operative intervention. It is often difficult to reduce such a complex fracture-dislocation because of the force that the muscles exert on the bone and the injured part of the spinal cord...

BACKGROUND: Minimally invasive spine (MIS) surgery utilizing tubular retractors has become an increasingly popular approach for decompression in the lumbar spine. However, a better understanding of appropriate indications, efficacious surgical techniques, limitations, and complication management is required to effectively teach the procedure and to facilitate the learning curve. OBJECTIVE: To describe our experience and recommendations regarding tubular surgery for lumbar disc herniations, foraminal compression with unilateral radiculopathy, lumbar spinal stenosis, synovial cysts, and dural repair...

BACKGROUND: Neurosurgical complications from epidural injections have rarely been reported. OBJECTIVE: To define the spectrum of complications from these procedures in order to identify risk factors and strategies for prevention. METHODS: A prospectively maintained database of 14 247 neurosurgical admissions over 8 yr was screened to identify patients who had suffered procedural complications associated with 1182 cervical and 4617 lumbar interlaminar epidural injection procedures performed at a single institution...

STUDY DESIGN: Survey. OBJECTIVE: To define the critical elements of common spine surgeries. SUMMARY OF BACKGROUND DATA: Despite significant relevance to the field of spine surgery, the term "critical element" of surgery has not been clearly defined. Every surgical procedure involves numerous steps, each with its own potential for complications and harm to the patient. Despite its crucial role in surgical training, billing, and the ethicality of concurrent surgery, the term "critical element" of surgery has not been defined...

BACKGROUND: Lumbar spinal stenosis is the most common indication for spine surgery in older adults. Interspinous process decompression (IPD) using a stand-alone spacer that functions as an extension blocker offers a minimally invasive treatment option for intermittent neurogenic claudication associated with spinal stenosis. METHODS: This study evaluated the 5-year clinical outcomes for IPD (Superion(®)) from a randomized controlled US Food and Drug Administration (FDA) noninferiority trial...

BACKGROUND: Parkinson's disease (PD) is a major risk factor during spine surgery, and its frequency is rising as the population ages. The study aim was to examine the influence of PD specifically on lumbar decompression surgery. METHODS: A retrospective review was performed of all patients with PD who underwent elective lumbar decompression surgery at two university hospital departments between December 2003 and July 2016. For each patient, two controls without PD were randomly selected among those who were matched for sex and age and had a similar year of surgery (±3) and comorbidity profile...

OBJECTIVE: Percutaneous endoscopic contralateral interlaminar lumbar foraminotomy (PECILF) for lumbar degenerative spinal stenosis is an established procedure. Better preservation of contralateral facet joint compared to that of the approach side has been demonstrated with uniportal bilateral decompression. The aim of this retrospective case series was to analyze the early clinical and radiological outcomes of standalone contralateral foraminotomy and lateral recess decompression using PECILF...

PURPOSE: To evaluate the clinical efficacy of CT-guided percutaneous huge ilio-psoas abscesses drainage combined with posterior approach surgery for the management of dorsal and lumbar spinal tuberculosis in 16 adult cases. METHODS: Between January 2006 and June 2013, a total of 16 dorsal and lumbar spinal tuberculosis patients with huge ilio-psoas abscesses underwent two-stage CT-guided percutaneous abscesses drainage and posterior debridement, decompression, intervertebral fusion and instrumentation...

BACKGROUND: There are no studies about the biomechanical analysis of lumbar decompression surgery in relation to degenerative changes of the lumbar spine. Therefore, the purpose of this study was to compare, by using finite element (FE) analysis, the biomechanical changes of the lumbar spine in terms of annulus stress and nucleus pressure after two different kinds of lumbar decompression surgery in relation to disc degenerative changes. METHODS: The validated intact and degenerated FE models (L2-5) were used in this study...

BACKGROUND: Anterior clinoidal meningiomas (ACM) are traditionally approached through transcranial routes. Due to their tendency to extend laterally and their proximity to vital neurovascular structures, the endoscopic transnasal suprasellar approach is still questionable. We present and describe an ACM case that underwent an endoscopic transnasal suprasellar approach, and provide a review of the literature and operative technique. CASE DESCRIPTION: A 56 year-old lady who presented with chronic left-sided decreased vision...

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A 52-year-old Japanese male professional diver was referred to our hospital for decompression illness (DCI). After 1 h of diving operation at 20 m below sea level, he complained of dyspnea, chest pain, and abdominal pain. He dove again, intending to ease the symptoms, but the symptoms were never relieved. He dove for a total of 4 h. No neurological abnormalities were observed. Computed tomography images revealed portal venous gas and mesenteric venous gas, in addition to bubbles in the femoral veins, pelvis, lumbar canal, intracranial sinuses, and joints...

STUDY DESIGN: Prospective cohort study. OBJECTIVE: Microsurgical bilateral decompression via a unilateral approach (MBDU), a minimally invasive surgical (MIS) decompression method, has been performed for numerous degenerative lumbar diseases, including degenerative lumbar scoliosis (DLS) or degenerative spondylolisthesis (DS), at our institution. In this study, we evaluated the appropriateness of MBDU for DLS or DS patients. METHODS: A total of 207 patients treated by MBDU were included (88 women and 119 men; mean age, 70 [40-86] years)...

BACKGROUND CONTEXT: The importance of surgeon volume as a quality measure has been defined for a number of surgical specialties. Meaningful procedural volume benchmarks have not been established, however, particularly with respect to lumbar spine surgery. PURPOSE: To establish surgeon volume benchmarks for the performance of four common lumbar spine surgical procedures (discectomy, decompression, lumbar interbody fusion, lumbar posterolateral fusion). STUDY DESIGN: Retrospective review of data in the Florida Statewide Inpatient Dataset (2011-2014)...

Remote cerebellar haemorrhage is a rare but serious complication after spinal surgery. Although the mechanism is not well known, it always occurs after loss of cerebrospinal fluid due to dural tear, not always identified, which produces remote venous bleeding. Prognosis depends largely on the severity of this bleeding. We report a case of 67-year-old female who suffered a cerebellar and subarachnoid haemorrhage and subdural haematoma after elective lumbar fusion surgery and eventually required decompressive craniectomy...

STUDY DESIGN: This is a retrospective study. PURPOSE: To determine the efficacy and safety of a posterior transpedicular approach with regard to functional and radiological outcomes in people with thoracic and thoracolumbar spinal tuberculosis. OVERVIEW OF LITERATURE: Spinal tuberculosis can cause serious morbidity, including permanent neurological deficits and severe deformities. Medical treatment or a combination of medical and surgical strategies can control the disease in most patients, thereby decreasing morbidity incidence...

STUDY DESIGN: Retrospective study. PURPOSE: We report the surgical outcomes of small degenerative lumbar scoliosis (DLS) patients treated by a short-segment fusion and followed for a minimum of 5 years. OVERVIEW OF LITERATURE: Several surgical options are available for the treatment of DLS, such as decompression only, decompression plus a short-segment fusion, or decompression with a long segment fusion. Few studies have evaluated the results of a short-segment fusion in patients with DLS over time...

BACKGROUND: Tandem spinal stenosis refers to spinal canal diameter narrowing in at least 2 distinct regions of the spine, most commonly the lumbar and cervical regions. This entity can be an asymptomatic radiographic finding, or it can present with severe myelopathy and lower-extremity symptoms. Tandem spinal stenosis may impact surgeon decision-making when planning either cervical or lumbar spine surgery, and there is currently no consensus in the literature regarding the treatment algorithm for operative intervention...