Lumbar decompression

BACKGROUND: Juxtafacet spinal cysts are cystic synovial lesions that are often indistinguishable clinically or radiologically and require histopathology analysis to confirm the diagnosis. Lumbar synovial cysts usually arising from the synovium of the facet joints. They have been described posterolateral or rarely in the posterior midline. However, we describe the first synovial cyst ventral to the dural sac. CASE DESCRIPTION: We report a lumbar 3-4 lesion causing cauda equina compression in a 57-year-old man who presented with 3 months history of low back pain and bilateral sciatica, intermittent urinary incontinence and erectile dysfunction...

Numerous interventions for neuropathic pain (NeuP) are available, but its treatment remains unsatisfactory. We systematically summarized evidence from systematic reviews (SRs) of randomized controlled trials on interventions for NeuP. Five electronic databases were searched up to March 2015. Study quality was analyzed using A Measurement Tool to Assess Systematic Reviews. The most common interventions in 97 included SRs were pharmacologic (59%) and surgical (15%). The majority of analyzed SRs were of medium quality...

OBJECTIVE Although rare, frontoethmoidal meningoencephaloceles continue to pose a challenge to neurosurgeons and plastic reconstructive surgeons. Especially when faced with limited infrastructure and resources, establishing reliable and safe surgical techniques is of paramount importance. The authors present a case series in order to evaluate a previously proposed concise approach for meningoencephalocele repair, with a focus on sustainability of internationally driven surgical efforts. METHODS Between 2001 and 2016, a total of 246 patients with frontoethmoidal meningoencephaloceles were treated using a 1-stage extracranial approach by a single surgeon in the Department of Neurosurgery of the Yangon General Hospital in Yangon, Myanmar, initially assisted by European surgeons...

BACKGROUND: Herniated intervertebral disc disease (HIVD) is a common cause of lower back and leg pain. Percutaneous endoscopic lumbar discectomy (PELD) is indicated when non-surgical treatments such as medication and interventions are intractable. Ruptured discs and loose fragments inside discs are removed during PELD. Nerve root decompression is usually assessed by visualizing the free movement of the traversing nerve root or epidural fat, the free passage of a probe into the epidural space, the depression of the annulus, and the removal of the expected ruptured discs and loose fragments based on preoperative magnetic resonance images (MRI)...

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...

The study was to comprehensively compare the postoperative outcome and imaging parameter characters in a short/middle period between the percutaneous endoscopic lumbar discectomy (PELD) and the internal fixation of bone graft fusion (the most common form is posterior lumbar interbody fusion [PLIF]) for the treatment of adjacent segment lumbar disc prolapse with stable retrolisthesis after a previous lumbar internal fixation surgery.In this retrospective case-control study, we collected the medical records from 11 patients who received PELD operation (defined as PELD group) for and from 13 patients who received the internal fixation of bone graft fusion of lumbar posterior vertebral lamina decompression (defined as control group) for the treatment of the lumbar disc prolapse combined with stable retrolisthesis at Department of Spine Surgery, the Third Hospital of Hebei Medical University (Shijiazhuang, China) from May 2010 to December 2015...

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...

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...

A 46-year-old man with over a 10-year history of gout complained of progressive bilateral buttock pain with numbness of legs for 4 months. Serum uric acid level was elevated. Lumbar radiographs showed decreased density of the bilateral L4-L5 facet joints. CT showed lytic lesions of the facet joints with hyperdense periarticular lesions. Enhanced MRI showed marked enhancement of these lesions. FDG PET/CT showed avid FDG uptake of the bony and periarticular lesions with SUVmax of 16.8. A decompressive posterior lumbar laminectomy with periarticular lesion resection was performed...

BACKGROUND: Previous reports suggest that patients with Parkinson's disease (PD) have increased complication rates following spine surgery however data from these reports are limited by small patient size. The aim of this study was to utilize the National Inpatient Sample (NIS) database to compare in-hospital complications for PD compared to patients without following elective lumbar spine surgery. METHODS: The NIS database was accessed to find patients who underwent lumbar spine surgery with and without a diagnosis of PD...

BACKGROUND: Spinal cysticercosis has been reported only in 0.7 to 3.0% of patients with neurocysticercosis. Most of the patients with spinal cysticercosis have a coexisting intracranial disease. Most often these present as intradural extramedullary lesions, involving thoracic and lumbar regions or intramedullary lesions. Intradural extramedullary primary spinal cysticercosis presenting as cervical myelopathy is extremely rare and not reported till date. CASE DESCRIPTION: The authors describe a 56 year old man from the northeastern part of India with progressive spastic quadriparesis...

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...

There is a lack of information and consensus regarding the optimal treatment for recurrent disc herniation previously treated by posterior discectomy, and no reports have described an anterior approach for recurrent disc herniation causing cauda equina syndrome (CES). Revision posterior decompression, irrespective of the presence of CES, has been reported to be associated with significantly higher rates of dural tears, hematomas, and iatrogenic nerve root damage. The authors describe treatment and outcomes in 3 consecutive cases of patients who underwent anterior lumbar discectomy and fusion (ALDF) for CES caused by recurrent disc herniations that had been previously treated with posterior discectomy...

STUDY DESIGN: Retrospective cohort study. OBJECTIVE: To investigate the effect depression has on the improvement of patient reported outcome measures (PROMs) following lumbar decompression. SUMMARY OF BACKGROUND DATA: Decompression without fusion is a viable treatment option for lumbar spine stenosis. Depression reportedly has a negative impact on PROMs after certain types of spine surgery, though verification of this with new, more precise outcome measures is needed...

A 23 year-old female was diagnosed with lumbar idiopathic intervertebral disc calcification associated with ossification of OLF. The patient underwent posterior decompression and posterolateral fusion with pedicle screw fixation, which achieved excellent clinical improvement. Surgical intervention of a posterior approach for decompression and instrumented fusion is indicated in cases that the spinal cord compression with neurologic deficits was involved.

Symptomatic spondylolisthesis patients may benefit from surgical decompression and stabilization. The standard (S) technique is a transforaminal lumbar interbody fusion (TLIF). Newer, minimally invasive (MI) techniques seem to provide similar results with less morbidity. We enrolled patients with at least 6 months of symptoms and image-confirmed low-grade spondylolisthesis, at a single academic institution, between 2011 and 2015. The patients were randomized to either S or MI TLIF. The primary outcome measure was the Oswestry Disability Index (ODI) improvement at 1 year...

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...

BACKGROUND: To evaluate the safety and effectiveness of argatroban for the prevention of venous thromboembolism (VTE) after posterior lumbar decompressive surgery. METHODS: Included in this retrospective study were 556 patients who underwent posterior lumbar decompressive surgery for trauma and degenerative diseases. They were divided into two groups: argatroban group (n = 274), and low molecular weight heparin (LMWH) group (n = 282). The occurrence of postoperative venous thrombosis and complications including hemorrhage and allergic reaction was compared between the two groups...

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...

PURPOSE: To find out the factors suggesting lumbar segmental instability in patients with degenerative spondylolisthesis (DS) on conventional magnetic resonance imaging (MRI). METHODS: Ninety-four patients with DS who underwent decompression surgery with or without fusion were selected. Patient demographics and findings on simple radiographs and MRI were analyzed. We divided patients into two groups by the presence of lumbar instability on simple standing plain radiographs and measured degeneration status of intervertebral discs and facet joints and distance of facet fluid signal on T2 axial MRI on each groups...