Lumbar decompression

AIM: The aim of this study is to evaluate the satisfaction of patients operated due to degenerative lumbar spinal diseases with dynamic stabilization with Polyetheretherketone (PEEK) rod and to share their radiological and clinical results (mid-term) with Visual Analog Scale(VAS) and Oswestry Disability Index(ODI) scores. MATERIAL AND METHODS: The preoperative and postoperative low back pain, leg pain VAS and ODI scores of 172 patients who were operated for degenerative spinal diseases were evaluated...

AIM: Lumbar spinal stenosis (LSS) can have an unfavorable impact on activities of daily living and walking distance. Bilateral decompression via unilateral approach (BDUA) could be an effective method of reducing pain, increasing walking distance, and improving disability, although some reports have shown that it could have poor outcomes in the long-term, particularly in older people and females. This study was conducted to investigate the mid-term efficacy of BDUA on symptoms and quality of life of patients, especially in elderly and/ or female patients with low grade (with percent slip 25%) degenerative spondylolisthesis or without spondylolisthesis...

Objective: To compare the long-term effectiveness of wheather posterior ligamentous complex (PLC) preserved between posterior fenestration decompression interbody fusion and posterior total laminectomy interbody fusion. Methods: The clinical data of 89 patients who suffered from single segmental degenerative diseases of lower lumbar spine and followed up more than 10 years after receiving lumbar spinal fusion between January 2000 and January 2005 were retrospectively analysed...

OBJECTIVEMinimally invasive lumbar unilateral tubular laminotomy for bilateral decompression has gradually gained acceptance as a less destabilizing but efficacious and safe alternative to traditional open decompression techniques. The authors have further advanced the principles of minimally invasive surgery (MIS) by utilizing working-channel endoscope-based techniques. Full-endoscopic technique allows for high-resolution off-axis visualization of neural structures within the lateral recess, thereby minimizing the need for facet joint resection...

BACKGROUND: Spine surgery has the potential to benefit from the use of 3D printing technology (additive manufacturing) particularly in cases of complex anatomical pathologies. Custom devices have the potential to reduce operative times, reduce blood loss, provide immediate stability and potentially improve fusion rates. CASE DESCRIPTION: A 34-year-old male presented with 3-year history of bilateral L5 radiculopathy due to bilateral L5 pars defect, and L5/S1 Degenerative Disc Disease and severe foraminal stenosis...

Background: Evaluate the current evidence in meta-analyses on posterior thoracolumbar minimally invasive surgery techniques and outcomes for degenerative conditions. Methods: A systematic review of the literature from 1950 to 2015. Results: The review of the literature yielded 34 meta-analysis studies evaluating posterior thoracolumbar minimally invasive techniques and outcomes for degenerative conditions. There were 11 studies included which investigated minimally invasive surgery (MIS) versus open posterior lumbar decompressions...

BACKGROUND: Fusion in addition to decompression has become the standard treatment for lumbar spinal stenosis with degenerative spondylolisthesis (DS). The evidence for performing fusion among these patients is conflicting and there is a need for further investigation through studies of high quality. The present protocol describes an ongoing study with the primary aim of comparing the outcome between decompression alone and decompression with instrumented fusion. The secondary aim is to investigate whether predictors can be used to choose the best treatment for an individual...

We describe the case of a 30-year-old patient who was referred for lumbar epidural corticosteroid injection due to right L5 radiculopathy. Two months earlier, MRI demonstrated a right large paracentral L4-L5 disk extrusion causing disabling L5 radiculopathy. The L4-L5 level was selected for interlaminar injection, using fluoroscopic guidance. During injection, the patient developed severe pain in both lower extremities. Thus, the procedure was immediately terminated. Paraplegia occurred within several minutes...

Gait analysis is relevant to a broad range of clinical applications in areas of orthopedics, neurosurgery, rehabilitation and the sports medicine. There are various methods available for capturing and analyzing the gait cycle. Most of gait analysis methods are computationally expensive and difficult to implement outside the laboratory environment. Inertial measurement units, IMUs are considered a promising alternative for the future of gait analysis. This study reports the results of a systematic validation procedure to validate the foot pitch angle measurement captured by an IMU against Vicon Optical Motion Capture System, considered the standard method of gait analysis...

Two major forms of physician reimbursement include Medicare (MCR; federally funded) and Medicaid (MCD; state funded). The only oversight provided to individual states for setting MCD reimbursement is that it must provide a standard payment that does not negatively affect patient care. The goals of this study were to determine the variability of MCD reimbursement for patients who require orthopedic procedures and to assess how this compares with regional MCR reimbursement. Medicaid reimbursement rates from each state were obtained for total knee arthroplasty, total hip arthroplasty, anterior cruciate ligament repair, rotator cuff repair, anterior cervical decompression and fusion, posterior lumbar decompression, carpal tunnel release, distal radius open reduction and internal fixation, proximal femur open reduction and internal fixation, and ankle open reduction and internal fixation...

STUDY DESIGN: Retrospective analysis. OBJECTIVE: To investigate gender differences in opioid use after lumbar decompression and fusion surgery for patients with symptomatic lumbar stenosis or spondylolisthesis. SUMMARY OF BACKGROUND DATA: Recent studies have demonstrated higher prevalence of chronic pain states and greater pain sensitivity among women compared with men. Furthermore, differences in responsivity to pharmacological and non-pharmacological treatments have been observed...

BACKGROUND CONTEXT: Routine use of magnetic resonance imaging (MRI) as a diagnostic tool in lumbar stenosis is becoming more prevalent due to the aging population. Currently, there is no clinical guideline to clarify the utility of repeat MRI in patients with lumbar stenosis, without instability, neurological deficits, or disc herniation. PURPOSE: To evaluate the utility of routine use of MRI as a diagnostic tool in lumbar stenosis, and to help formulate clinical guidelines on the appropriate use of preoperative imaging for lumbar stenosis...

A 75-year-old female patient with lumbar spinal stenosis underwent posterior lumbar spinal fusion and posterolateral interbody fusion under general anesthesia. When the patient was positioned prone on the Jackson spine table before the surgery, a sudden severe hypotension and hemodynamic collapse developed. This circulatory collapse was refractory to intravascular volume expansion, inotropes and vasopressors. Application of external abdominal support immediately restored hemodynamics. The Jackson spine table allowed the abdomen to hang freely, providing abdominal decompression as well as resulting in the severely sagged abdomen...

STUDY DESIGN: This was a randomized clinical trial. OBJECTIVE: To compare the efficacy and safety of nonsteroidal anti-inflammatory drug and opioid for acute pain management after lumbar decompressive surgery. SUMMARY OF BACKGROUND DATA: Multimodal analgesia is associated with synergistic effects while reducing opioid-related adverse effects. However, there is no consensus on the ideal multimodal analgesic regimen. We assumed that each agent in various multimodal regimens under different conditions may have different effects...

OBJECTIVES: Multilevel noncontiguous thoracic and lumbar spinal tuberculosis (MNST) is a relatively rare entity. The objective of this retrospective study was to investigate whether a technique involving a one-stage posterior debridement and decompression, combined with an intervertebral fusion and posterior instrumentation, is effective for treating MNST. METHODS: Thirteen patients, with an average age of 40.69 (18-67) years, who had MNST and were surgically treated in our department from January 2008 to October 2013, were reviewed...

Introduction: Retroperitoneal hemorrhage has been sparsely reported with warfarin therapy. In this paper, we describe a case of spontaneous retroperitoneal hematoma causing femoral neuropathy following treatment with low molecular weight heparin. Case Report: A 65-year-old gentleman had presented with acute onset left-sided thigh pain, paraesthesia, and weakness along with lower backache. On deeper introspection, our patient had, in the recent past, been thrombolyzed for pulmonary embolism...

Objective: Endoscopic surgeries have been attempted in the field of lumbar decompression and fusion surgery in the past decade. Percutaneous endoscopic lumbar interbody fusion (PELIF) is a new-emerging technique taking advantages of an anatomical (Kambin's triangle) to achieve simultaneous decompression and fusion under endoscopic visualization. The purpose of this study is to evaluate the feasibility and safety of PELIF technique with general anesthesia and neuromonitoring. Methods: The authors present the details of PELIF technique with general anesthesia and neuromonitoring...

BACKGROUND: The degree to which extended length of stay (LOS) after surgery represents patient illness or post-operative complications remains unknown. The purpose of this study is to investigate the influence of post-operative complications and patient comorbidities on the variance in hospitals' extended LOS after lumbar spine surgery. METHODS: Data from the American College of Surgeons National Surgical Quality Improvement Program was analyzed from January 1, 2008 through December 31, 2014...

OBJECTIVE: To investigate whether preoperative presence of degenerative spondylolisthesis (DS) worsens the outcome of patients undergoing decompression alone for degenerative lumbar stenosis. METHODS: We conducted a comprehensive search in the PubMed, Embase, and Cochrane Library databases. All comparative studies were included in this meta-analysis. The literature search, data extraction, and quality assessment were conducted by two independent reviewers. The functional outcomes were clinical scores and reoperation rate...

OBJECTIVE: The surgical management of high-grade lumbar spondylolisthesis (HGLS) is complex and aims to achieve both a solid fusion that is able to support the high shear forces of the lumbosacral junction, as well as neural decompression. We performed a systematic literature review of the safety and efficacy of posterior transdiscal (PTD) screw fixation from L5S1 for HGLS and its variations. METHODS: A systematic literature review following the PRISMA guidelines was performed in the PubMed database of the studies describing the use of PTD screw fixation for HGLS...