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Lumbar And Stenosis

Dongxiao Xie, Jinniu Zhang, Wenyuan Ding, Sidong Yang, Dalong Yang, Lei Ma, Jingtao Zhang
PURPOSE: While many studies have explored the association between paravertebral muscle (PVM) change and low back pain/lumbar spinal stenosis, little is known about PVM change in adult degenerative scoliosis (ADS). The present study explored the PVM change in ADS and investigated its association with bony structural parameters. METHODS: We evaluated 78 patients in ADS without radiculopathy (ADS group) and 65 healthy persons without degenerative lumbar diseases (control group)...
March 21, 2019: European Spine Journal
Murat Şakir Ekşi, Veli Umut Turgut, Emel Ece Özcan-Ekşi, Abuzer Güngör, Fahriye Nur Tükel Turgut, M Necmettin Pamir
BACKGROUND: Serotonin syndrome is a common disease entity and could result in death if missed. Incidence of SS is underestimated due to misdiagnosis of many cases, especially the ones with less severe presentation. Many medications have been depicted as the source of SS. We present a case of serotonin syndrome in a patient who received intravenous tramadol and oral gabapentin as pain management following spine surgery. CASE PRESENTATION: A 66-year-old man was admitted to our outpatient clinic with walking difficulties for 2 months...
March 18, 2019: World Neurosurgery
Angelo Tarullo, Antonella Tarullo, Emanuela Lacatena, Luigi Santacroce, Angelo Michele Inchingolo, Giuseppina Malcangi, Salvatore Scacco, Margherita Fanelli, Raffaele Cagiano, Francesco Inchingolo, Monica Caprio, Gianna Dipalma, Andrea Ballini, Antonietta Clemente, Alessio Danilo Inchingolo, Francesco Girolamo, Maria Tattoli
BACKGROUND: Management of neuropathic pain (Neu P) is complex and difficult. Although there are several therapeutic options, treatment with Neu P is often inadequate, which led to undertreated patients. Thus, it would be desirable, for Neu P treatment, further multimechanistics approaches. OBJECTIVE: The aim of the present study was to evaluate, in Neu P management, the effectiveness of "FISIONERV, a gel for topical use. SETTING: This study was conducted in the "Rehabilitation Unit of N...
January 24, 2019: Acta Bio-medica: Atenei Parmensis
Shadi Messiah, Antony R Tharian, Kenneth D Candido, Nebojsa Nick Knezevic
PURPOSE OF REVIEW: With an aging population and increased prevalence of the disease, we set out to evaluate the validity of current diagnostic criteria for neurogenic claudication as well as the efficacy of the treatment options for the main cause, lumbar spinal stenosis (LSS). RECENT FINDINGS: Epidural steroid injections (ESI) were most efficacious when the injectate is a steroid combined with lidocaine or lidocaine only. There are promising results regarding the efficacy of the minimally invasive lumbar decompression (MILD) procedure as well as interspinous process spacers (IPS) compared to surgical alternatives...
March 19, 2019: Current Pain and Headache Reports
Sertac Kirnaz, Rodrigo Navarro-Ramirez, Christoph Wipplinger, Franziska Anna Schmidt, Ibrahim Hussain, Eliana Kim, Roger Härtl
This video demonstrates the workflow of a minimally invasive transforaminal interbody fusion (MIS-TLIF) using a portable intraoperative CT (iCT) scanner, (Airo®, Brainlab AG, Feldkirchen, Germany), combined with state-of-the-art total 3D computer navigation. The navigation is used not only for instrumentation but also for intraoperative planning throughout the procedure, inserting the cage, therefore, completely eliminating the need for fluoroscopy. In this video, we present a case of a 72-yr-old female patient with a history of lower back pain, right lower extremity radicular pain and weakness for 2 yr due to L4-L5 spondylolisthesis with instability and severe lumbar spinal stenosis...
March 19, 2019: Operative Neurosurgery (Hagerstown, Md.)
Jongchul Chung, Changbong Kong, Woosung Sun, Dohyung Kim, Hyungdong Kim, Heungtae Jeong
BACKGROUND AND STUDY AIMS/OBJECTIVE:  Clinical outcomes of percutaneous endoscopic lumbar foraminoplasty (PELF) performed for lumbar foraminal stenosis (LFS) have been reported in the literature. However, no study has reported the radiographic changes in magnetic resonance imaging (MRI) after surgery. This report presents the clinical outcome as well as radiographic changes in MRI after PELF for elderly patients with unilateral radiculopathy. We also describe detailed operative nuances to expand the foraminal space and mobilize the affected nerve root...
March 18, 2019: Journal of Neurological Surgery. Part A, Central European Neurosurgery
Ju-Eun Kim, Dae-Jung Choi, Eugene J Park
BACKGROUND: Symptomatic postoperative spinal epidural hematoma is a serious complication that may occur after lumbar spine surgery. Authors analyzed epidural hematoma using postoperative MRI after biportal endoscopic spinal surgery and the impact of which to the clinical outcome. METHODS: The subject of this study were 158 patients who underwent single-level decompression using the biportal endoscopic spinal surgery technique from 2015 to 2017. MRI was performed in all patients before and after surgery, and postoperative MRI was used to identify epidural hematoma...
March 13, 2019: World Neurosurgery
H Bahadir Gokcen, Cagatay Ozturk
BACKGROUND: Achondroplasia, a genetic disorder of bone growth, produces specific clinical features of the extremities and spine. Spinal stenosis, seen in patients with achondroplasia, is a congenital disorder related to premature fusion of the pedicles to the lamina. It can be caused by ossification of the ligamentum flavum, which is rare in patients with achondroplasia. CASE PRESENTATION: We report a rare congenital spinal stenosis with ossification of the ligamentum flavum and thoracolumbar kyphosis deformity in a 24-year-old man with dwarfism and achondroplasia...
March 12, 2019: World Neurosurgery
Chang Kyu Lee, Sun Kyu Choi, Dong Ah Shin, Seong Yi, Yoon Ha, Keung Nyun Kim, Insoo Kim
PURPOSE: To evaluate the relationship between comorbidities, medical cost, and surgical outcome in patients with lumbar spinal stenosis (LSS) and diabetes mellitus (DM). METHODS: Data on patients with LSS (n = 14,298) were collected from the Korean National Health Insurance Service database from 2005 to 2007. After 8 years of follow-up, a "DM group" (n = 3,478) and a "non-DM group" (n = 10,820) were compared according to outcome measures. Cox proportional hazard regressions were performed to examine the relationship between DM, hypertension (HTN), cardiovascular disease (CVD), chronic kidney disease (CKD), cerebrovascular disease (CbVD), and surgery for LSS...
2019: PloS One
G A Korshunova, A E Shul'ga, V V Zaretskov, A A Smol'kin
AIM: To estimate the character of neurophysiological monitoring in patients with thoracic and lumbar spine injuries at different treatment stages. MATERIAL AND METHODS: Thirty-eight patients with non-complicated (22 patients, group 1) and complicated (16 patients, group 2) thoracic and lumbar spine injuries underwent electroneuromyography (ENM) and transcranial magnetic stimulation (TMS). The examination was performed at early (up to 2 weeks) and later (more than 1 month) post-injury periods, before the operation and on the 10th day after decompressing-stabilizing interventions...
2019: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
Kai-Uwe Lewandrowski
OBJECTIVES: The aim of this study was to analyze the accuracy and positive predictive value (PPV) of preoperative lumbar MRI grading for successful outcome after outpatient endoscopic decompression for lumbar foraminal and lateral recess stenosis. Lumbar MRI is commonly employed in preoperative decision making to identify symptomatic pain generators amenable to surgical decompression. However, its accuracy and positive predictive value for successful postoperative pain relief after endoscopic transforaminal decompression for sciatica-type back and leg pain has not been reported...
April 2019: Clinical Neurology and Neurosurgery
Kai Zhu, Shuaifeng Yan, Song Guo, Jinyu Tong, Cong Li, Jun Tan, Weiping Wan
BACKGROUND: This study was performed to investigate the morphological changes of contralateral intervertebral foramen (IVF) based on computed tomography images of patients with lumbar spinal stenosis after unilateral transforaminal lumbar interbody fusion (TLIF) and to compare the influence of different orientation of cage insertion on these changes. METHODS: This is a retrospective cohort study. Sixty-nine patients with lumbar spinal stenosis who had undergone single-level unilateral TLIF were retrospectively analyzed...
March 13, 2019: Journal of Orthopaedic Surgery and Research
Hiroaki Nakashima, Tokumi Kanemura, Kotaro Satake, Yoshimoto Ishikawa, Jun Ouchida, Naoki Segi, Hidetoshi Yamaguchi, Shiro Imagama
Study Design: Prospective cohort study. Purpose: This study aimed to identify risk factors for unplanned second-stage decompression for postoperative neurological deficit after indirect decompression using lateral lumbar interbody fusion (LLIF) with posterior fixation. Overview of Literature: Indirect lumbar decompression with LLIF has been used as a minimally invasive alternative to direct decompression to treat degenerative lumbar diseases requiring neural decompression...
March 15, 2019: Asian Spine Journal
Hadi Sasani, Bilgehan Solmaz, Mehdi Sasani, Metin Vural, Ali Fahir Ozer
OBJECTIVE: To study the efficacy of lumbar axial loading (AL) MRI in the suspected patients with lumbar spinal stenosis (LSS), with and without AL compression. SUMMARY OF BACKGROUND DATA: Supine MRI is used in the assessment of patients with lumbar spinal stenosis (LSS). However, MRI findings may poorly correlate with neurological findings due to the morphological changes of the lumbar spinal canal between upright standing and supine positions. In patients without significant stenosis in routine lumbar MRI, by applying AL, MRI can show significant LSS...
March 8, 2019: World Neurosurgery
A S Carr, S Shah, D Choi, J Blake, R Phadke, J Gilbertson, C J Whelan, A D Wechalekar, J D Gillmore, P N Hawkins, M M Reilly
Here we describe a patient with genetically confirmed ATTR, a family history of the disease and histological confirmation following carpal tunnel release surgery but no other manifestations. The first major neurological or systemic manifestation was cauda equina syndrome with ATTR deposits contributing to lumbar spinal stenosis. Recent gene therapy trials showed improvement in the neuropathy in TTR amyloidosis. This case highlights the need for awareness of the heterogeneous neurological phenotype seen in ATTR to aid earlier diagnosis especially now that disease modifying therapies are available...
March 7, 2019: Journal of Neuromuscular Diseases
Masaaki Machino, Kei Ando, Kazuyoshi Kobayashi, Kyotaro Ota, Masayoshi Morozumi, Satoshi Tanaka, Keigo Ito, Fumihiko Kato, Naoki Ishiguro, Shiro Imagama
BACKGROUND: Optimal treatment of lumbar spinal stenosis (LSS) with neurological deficit due to osteoporotic vertebral fractures (OVFs) has been controversial. We assessed the usefulness, safety, and efficacy of posterior lumbar interbody fusion (PLIF) for LSS with neurological deficit due to OVFs and compared this procedure to posterior/anterior combined surgery (PACS). METHODS: Of 36 consecutive patients with LSS with neurological deficit due to OVFs, 15 underwent PLIF (6 males, 9 females; mean age, 74 years), and 21 underwent PACS (4 males, 17 females; mean age, 70 years)...
March 7, 2019: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
Seung Myung Wi, Hui Jong Lee, Sam Yeol Chang, Oh Hyo Kwon, Choon-Ki Lee, Bong-Soon Chang, Hyoungmin Kim
Background: In lumbar spinal stenosis, spinous process-splitting decompression has demonstrated good clinical outcomes with preservation of the posterior ligamentous complex and paraspinal muscles in comparison to conventional laminectomy, but the radiological consequence and clinical impact of the split spinous processes have not been fully understood. Methods: Seventy-three patients who underwent spinous process-splitting decompression were included. The bone union rate and pattern were evaluated by computed tomography performed 6-18 months after surgery and compared among subgroups divided according to the number of levels decompressed and the extent of spinous process splitting...
March 2019: Clinics in Orthopedic Surgery
Dae-Jung Choi, Ju-Eun Kim
Background: Biportal endoscopic spine surgery (BESS) is a recent addition to minimally invasive spine surgery treatments. It boasts excellent magnification and fine discrimination of neural structures. Selective decompression with preservation of facet joints for structural stability is also feasible owing to access to the spinal canal and foramen deeper inside. This study has a purpose to investigate clinical benefits of BESS for spinal stenosis in comparison to the other common surgical treatments such as microscopic decompression-only (DO) and fusion and instrumentation (FI)...
March 2019: Clinics in Orthopedic Surgery
Xin-Feng Li, Lin-Yu Jin, Zhen-Dong Lv, Xin-Jin Su, Kun Wang, Xiao-Xing Song, Hong-Xing Shen
PURPOSE: Decompression alone is a treatment option in patients with lumbar spinal stenosis (LSS) and degenerative lumbar spondylolisthesis (DLS). This study aims to describe the procedure of percutaneous transforaminal endoscopic ventral decompression technique and to demonstrate the clinical outcomes. METHODS: Two years of retrospective data were collected from 26 patients with predominant unilateral leg pain caused by LSS and low-grade DLS (Meyerding grades I and Ⅱ)...
February 27, 2019: World Neurosurgery
Eliezer Sidon, Shai S Shemesh, Lisa Mor-Yossef Moldovan, Yarden Wiesenfeld, Nissim Ohana, Dafna Benayahu
Lumbar spinal canal stenosis (LSCS) is a degenerative disease observed by hypertrophy of the ligamentum flavum (LF) that cause compression of the lumbar neural content. Diabetes mellitus (DM) is a risk factor for the disease and we have shown previously that DM increases the fibrosis and elastic fiber loss in patients with LSCS. The purpose of this study was to find the proteins that play a role in the development of this clinical pathogenesis and the effect of DM on protein expression. LF tissue retrieved from patients diagnosed with LSCS, some were also diagnosed with DM, were compared with LF from patients diagnosed with herniated nucleus pulposus (HNP)...
March 1, 2019: Journal of Cellular Biochemistry
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