Effectiveness of posterior decompression techniques compared to conventional laminectomy for lumbar stenosis

Overdevest, Gijsbert M; Jacobs, Wilco; Vleggeert-Lankamp, Carmen; Thomé, Claudius; Gunzburg, Robert; Peul, Wilco

doi:10.1002/14651858.cd010036

Cited by 30 publications

(43 citation statements)

References 35 publications

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“…However, partial removal of the facet joint may lead to joint instability and subsequent spondylolisthesis and scoliosis (35). Biomechanical studies have demonstrated that facet joints constrain axial rotation and flexion (36,37).…”

Section: Discussionmentioning

confidence: 99%

Interlaminar endoscopic lateral recess decompression—surgical technique and early clinical results

Birjandian¹,

Emerson²,

Telfeian³

et al. 2017

J. Spine Surg.

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Background: Lateral recess stenosis is a common pathology causing de-novo or residual radicular pain following lumbar spine surgery. Diagnostic criteria and treatment strategies for symptomatic lateral recess stenosis are not well established. Methods:We identified ten patients in our prospective patient database (n=146) who underwent endoscopic interlaminar decompression for unilateral symptomatic lateral recess stenosis. Lateral recess height and angle were measured on axial T2-weighted MRI. Values from the symptomatic side were compared to the contralateral side which served as asymptomatic control. Oswestry Disability Index (ODI) and Visual Analogue Scale (VAS) for back and leg pain were collected preoperatively, postoperatively and at last follow-up.Results: Preoperative MRI revealed that both lateral recess angle and height were significantly smaller on the symptomatic compared to the asymptomatic side (angle: 19.3˚ vs. 35.7˚; height: 2.9 vs. 5.7 mm; P<0.01).All patients tolerated endoscopic interlaminar decompression well and half of the patients were discharged on the day of surgery. At last follow-up (12.6±1.7 months), 8 out of 10 patients experienced a minimally clinically important improvement of their VAS for ipsilateral leg pain, which improved from 7.2±0.5 preoperatively to 2.5±0.8 postoperatively (P=0.001). The back pain VAS also improved (preoperatively 5.1±1.1 vs. postoperatively 1.7±0.9, P<0.05). The ODI improved from 50±5.8 preoperatively to 22.2±5.1 at last follow-up (P=0.001). One patient experienced persistent leg pain.Conclusions: Lateral recess height and angle correlate with symptomatic lateral recess stenosis which is effectively treated utilizing interlaminar endoscopic lateral recess decompression.

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Section: Discussionmentioning

confidence: 99%

Interlaminar endoscopic lateral recess decompression—surgical technique and early clinical results

Birjandian¹,

Emerson²,

Telfeian³

et al. 2017

J. Spine Surg.

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“…We employed the methods of Overdevest et al 60 in setting the MCID to a 30% improvement from the mean of the baseline level of pain. This corresponded to 1.5 points on a VAS and 2.0 points on an NRS for the data examined here.…”

Section: Methodsmentioning

confidence: 99%

The effectiveness of extracorporeal shockwave therapy in common lower limb conditions: a systematic review including quantification of patient-rated pain reduction

Korakakis

Whiteley

Tzavara³

et al. 2017

Br J Sports Med

152

118

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“…Minimally invasive surgery has conflicting evidences 72) . The evidence supporting superiority of posterior decompression techniques is of low quality 73) . The large cohort study suggests that addition of fusion to decompression is not associated with an improved outcome 74) .…”

Section: Surgerymentioning

confidence: 99%

The Recent Trend in Diagnosis and Treatment of Chronic Low Back Pain

Kikuchi

2017

Spine Surg Relat Res

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Abstract:Introduction: Development of evidence-based medicine has made a big change in diagnosis and treatment of chronic low back pain. The recent trend is assessed through a review of literature. Methods: The articles published in these 10 years are reviewed, and important points are examined. Results: In diagnosis, challenges for history taking and limit of imaging or clinical guidelines are revealed. In treatment, cognitive behavioral treatment and exercises are proved effective. Sleep disturbance has recently attracted attention as a factor associated with low back pain. Cost-effectiveness of diagnosis and treatment modalities has come to be emphasized. Conclusions: Diagnosis and treatment of chronic low back pain have been significantly changing. Multidisciplinary and multidimensional approach is essential. Chronic low back pain should be treated as a total pain, not a local pain.

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Effectiveness of posterior decompression techniques compared to conventional laminectomy for lumbar stenosis

Cited by 30 publications

References 35 publications

Interlaminar endoscopic lateral recess decompression—surgical technique and early clinical results

Interlaminar endoscopic lateral recess decompression—surgical technique and early clinical results

The effectiveness of extracorporeal shockwave therapy in common lower limb conditions: a systematic review including quantification of patient-rated pain reduction

The Recent Trend in Diagnosis and Treatment of Chronic Low Back Pain

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