Decompressive Surgery for Typical Lumbar Spinal Stenosis

Hansraj, Kenneth K.; Cammisa, Frank P.; O’Leary, Patrick F.; Crockett, Heber C.; Fras, Christian I.; Cohen, Matthew S.; Dorey, Frederick J.

doi:10.1097/00003086-200103000-00003

Cited by 69 publications

(42 citation statements)

References 55 publications

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“…Re-operation rates for decompressive laminectomy have been reported to vary from 5 to 23% [5,12,13,18]. We found an 11% re-operation rate after 10 years compared with a US study by Katz et al [18] that presented a 23% re-operation rate 8 years after surgery.…”

Section: Discussioncontrasting

confidence: 47%

“…During the same period as the study by Katz and co-workers, Caputy and Luessenhop [5] also reported a comparable high re-operation rate of 18% after 5 years. In a cohort from 1991 to 1992, Hanraj et al [12] found only 5% re-operations after 5 years.…”

Section: Discussionmentioning

confidence: 97%

“…The rates of re-operation after decompressive spinal stenosis surgery vary from 5 to 23% [5,12,13,18]. Most previous studies of the re-operation rate of spinal stenosis surgery have been based on selected patient groups, either from different regions, hospitals, or patients belonging to certain healthcare insurance programs.…”

Section: Introductionmentioning

confidence: 99%

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Spinal stenosis re-operation rate in Sweden is 11% at 10 years—A national analysis of 9,664 operations

et al. 2005

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Re-operation rates in spinal stenosis surgery vary between 5 and 23%. Most previous studies have been based on selected patients groups. We analysed the 10-year lumbar spinal stenosis re-operation rate from comprehensive Swedish national data during 1987-1999. The mean length of stay decreased from 2 weeks in 1987 to 1 week in 1999. Of 9,664 patients, 628 (6.5%) were re-operated. Within 30 days after the first spinal stenosis operation, 0.15% of the parients were re-operated. The 1-, 2-, 5-, and 10-year reoperation rates were 2, 5, 8 and 11%, respectively. The rate lowered by 31% over time. Adding a fusion may lower the re-operation risk, an observation which can only be evaluated in randomised trial.

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Section: Discussioncontrasting

confidence: 47%

Section: Discussionmentioning

confidence: 97%

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Spinal stenosis re-operation rate in Sweden is 11% at 10 years—A national analysis of 9,664 operations

et al. 2005

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“…Respecto al tratamiento quirúrgico [18][19][20][21] , este tiene los objetivos de mejorar la calidad de vida del paciente, disminuir tanto el dolor lumbar como radicular y mejorar el défi cit neurológico. Se plantea la cirugía cuando existe una falta de respuesta a tratamiento conservador por al menos 12 semanas asociado a una alteración signifi cativa en la realización de actividades de la vida diaria objetivables con escalas de Oswestry Disability Index (ODI) y 36 Item Short Form General Health Survey (SF-36) 22-23 y dolor radicular moderado o severo basado en el EVA.…”

Section: Tratamientounclassified

“…Sin embargo, 7-10 años posterior a la cirugía al menos 1/3 de los pacientes refi eren reinicio de dolor lumbar. Los índices de reoperación a 10 años plazo van de los 10-23% 21,41 .…”

Section: Tratamientounclassified

Actualización en estenorraquis lumbar: diagnóstico, tratamiento y controversias

2011

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Spinal lumbar stenosis. An updatepuc.cl L a raquiestenosis lumbar se defi ne como una disminución del área del canal raquídeo que puede comprimir las raíces nerviosas. La incidencia en las imágenes de este cuadro va de 1,7% a 13,1% 1 , sin embargo, la incidencia clí-nica es menor y genera sus síntomas con mayor frecuencia entre la 5° y la 7° década de la vida. Su causa principal son los cambios degenerativos de la columna vertebral. Se produce con igual frecuencia entre hombres y mujeres, excepto cuando esta patología se asocia a espondilolistesis, la cual es de mayor incidencia en mujeres. No hay asociación con actividad laboral o física. AnatomíaLa columna vertebral está constituida por componentes óseos con sus ligamentos, articulaciones, discos y músculos. El raquis consta de 33 vértebras: 7 cervicales, 12 dorsales, 5 lumbares, 5 sacras (fusionadas) y el cóccix, que resulta de la unión de las 4 vértebras coccígeas. Las vértebras cervicales, dorsales y lumbares se articulan entre sí mediante los discos intervertebrales y las articulaciones facetarias.Los elementos ligamentarios proporcionan una estructura estable y móvil. Entre los ligamentos de mayor signifi cación fi guran: -Longitudinal anterior. -Longitudinal posterior, que forma parte de la pared anterior del canal medular. -Ligamento amarillo, que se insertan entre las láminas, e integran la pared posterior del canal raquídeo. -Interespinosos y supraespinosos.La unidad vertebral está constituida por 2 vertebras más los ligamentos, articulaciones facetarias y el disco intervertebral entre ambas vértebras.

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Operative Therapie des engen Spinalkanals

Feldmann

Wittenberg

2003

Der Orthop�de

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Surgical treatment of lumbar spinal stenosis is aimed at decompressing the structures of the spinal canal. Several surgical techniques have been described over the last few years. This article gives a survey of the surgical procedures used for the treatment of spinal stenosis. When comparing and discussing indications and current surgical techniques used for spinal stenosis, one can describe some general tendencies: if the symptoms are severe or disabling and do not respond to appropriate conservative treatment, or if the patient is not able to cope with the pain any longer and views his or her quality of life as unacceptable, surgery is indicated. If the symptoms are mainly radicular, (microsurgical) decompression should be performed. If back pain is the main problem combined with preoperative evidence of segmental instability, spondylolisthesis, or scoliosis, one should consider spinal fusion in addition to an appropriate decompression. Further investigations are necessary to exactly find out the appropriate indications for a fusion and to answer the question of whether spinal instrumentation should be used.

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Decompressive Surgery for Typical Lumbar Spinal Stenosis

Cited by 69 publications

References 55 publications

Spinal stenosis re-operation rate in Sweden is 11% at 10 years—A national analysis of 9,664 operations

Spinal stenosis re-operation rate in Sweden is 11% at 10 years—A national analysis of 9,664 operations

Actualización en estenorraquis lumbar: diagnóstico, tratamiento y controversias

Operative Therapie des engen Spinalkanals

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