Lumbar Spinal Stenosis: Therapeutic Options Review

Costandi, Shrif; Chopko, Bohdan W.; Mekhail, Mena; Dews, Teresa E.; Mekhail, Nagy

doi:10.1111/papr.12188

Cited by 52 publications

(47 citation statements)

References 83 publications

(119 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…33 Various imaging modalities are utilized to diagnose and characterize LCS including static and dynamic radiography, CT, CT myelography, and the gold standard MRI. 9,57 In the present study, we adopted imaging with CT to confirm central LCS diagnosis via measurement of cross-sectional diameter of the dural sac at the disc level.…”

Section: Discussionmentioning

confidence: 99%

Microendoscopic bilateral Decompression via Unilateral Approach in Single and Multiple Level Lumbar Canal Stenosis: A Series of 583 Cases

Kabil

Ebrahim

2017

Egyptian Spine Journal

View full text Add to dashboard Cite

Background Data: Traditionally, lumbar canal stenosis (LCS) has been treated with conventional laminectomy involving wide resection of posterior supporting structures of the lumbar spine such as the supraspinous and inter-spinous ligamentum complex, the spinous process as well as wide areas of the lamina. In addition, this required a large incision of the skin and underlying musculoligamentous complex (posterior tension band). Purpose: The current study focuses on the clinical outcome and utility of minimally invasive microendoscopic decompression from a unilateral approach in surgical management of patients with single and multiple level lumbar canal stenosis. The objective is to describe the indications, significance and applications of endoscopic spine surgery in patients with single and multiple level LCS. Additionally, to highlight important anatomical perspectives of the technique and share surgical experience and results. Study Design: A retrospective clinical case study. Patients and Methods: From May 2008 to January 2016, 583 consecutive patients were treated for LCS and included in this study. Patients' main complaint was bilateral neurogenic claudication in addition to back pain and sciatic neuralgia. Single level decompression was performed in 468 (80%) patients and multiple level decompressions in 115 (20%) patients. Magnetic resonance imaging (MRI), computed tomography (CT) scan and plain X-rays were performed for all patients to confirm evidence of central stenosis and then repeated postoperatively. All patients were followed up for at least 3 months and their data collected. Clinical and functional outcomes were assessed using Visual Analogue Scale (VAS) and the Japanese Orthopedic Association Score (JOA) score for lumbar disease. Results: Compared to preoperative complaint, there was an improvement of back pain in 77.9% of patients and in radiating leg pain in 86.3%. With regards to functional outcomes, median preoperative JOA score was 14.93 ± 0.48 and improved postoperatively to 27.17 ± 1.45 (p < 0.001). The mean operating time per level was 78 minutes, and the mean intraoperative blood loss per level was 18 ml. Complications mainly included dural tears in 27 (4.6%) patients, transient postoperative dysesthesia in 46/583 (7.9%) patients and excess bony work in the form of unintended medial facetectomy in 38/583 (6.5%) patients and fracture of the spinous process in 3 (0.5%) patients.

show abstract

Section: Discussionmentioning

confidence: 99%

Microendoscopic bilateral Decompression via Unilateral Approach in Single and Multiple Level Lumbar Canal Stenosis: A Series of 583 Cases

Kabil

Ebrahim

2017

Egyptian Spine Journal

View full text Add to dashboard Cite

show abstract

“…The first treatment option is conservative therapy [2]. If patient symptoms worsen and/or conservative treatment fails, surgical decompression becomes a treatment option with potentially favorable results [3,4]. In a 10-year perspective, decompression appears to be beneficial over conservative treatment [5].…”

Section: Introductionmentioning

confidence: 98%

Superior outcomes of decompression with an interlaminar dynamic device versus decompression alone in patients with lumbar spinal stenosis and back pain: a cross registry study

Röder

Baumgartner

Berlemann³

et al. 2015

Eur Spine J

View full text Add to dashboard Cite

In the short-term, lumbar decompression with coflex® compared with decompression alone in patients with LSS and pronounced LBP at baseline is a safe and effective treatment option that appears beneficial regarding clinical and functional outcomes. However, residual confounding of non-measured covariables may have partially influenced our findings. Also, despite careful inclusion and exclusion of cases the cross registry approach introduces a potential for selection bias that we could not totally control for and that makes additional studies necessary.

show abstract

“…Lumbar spinal stenosis (LSS) results from degenerative changes in the spinal canal and is the most common spinal disease in elderly individuals [1–3]. It typically presents with buttock or low back pain, sensory and motor disturbances in the lower leg, and neurogenic intermittent claudication [2, 4].…”

Section: Introductionmentioning

confidence: 99%

Optimal Cut-Off Value of the Superior Articular Process Area as a Morphological Parameter to Predict Lumbar Foraminal Stenosis

Lim

Choi

Cho

et al. 2017

Pain Research and Management

View full text Add to dashboard Cite

Background. We devised a new morphological parameter called the superior articular process area (SAPA) to evaluate the connection between lumbar foraminal stenosis (LFS) and the superior articular process. Objective. We hypothesized that the SAPA is an important morphologic parameter in the diagnosis of LFS. Methods. All patients over 60 years of age were included. Data regarding the SAPA were collected from 137 patients with LFS. A total of 167 control subjects underwent lumbar magnetic resonance imaging (MRI) as part of a routine medical examination. We analyzed the cross-sectional area of the bone margin of the superior articular process at the level of L4-L5 facet joint in the axial plane. Results. The average SAPA was 96.3 ± 13.6 mm2 in the control group and 128.1 ± 17.2 mm2 in the LFS group. The LFS group was found to have significantly higher levels of SAPA (p < 0.001) in comparison to the control group. In the LFS group, the optimal cut-off value was 112.1 mm2, with 84.4% sensitivity, 83.9% specificity, and AUC of 0.94 (95% CI: 0.91–0.96). Conclusions. Higher SAPA values were associated with a higher possibility of LFS. These results are important in the evaluation of patients with LFS.

show abstract

Lumbar Spinal Stenosis: Therapeutic Options Review

Cited by 52 publications

References 83 publications

Microendoscopic bilateral Decompression via Unilateral Approach in Single and Multiple Level Lumbar Canal Stenosis: A Series of 583 Cases

Microendoscopic bilateral Decompression via Unilateral Approach in Single and Multiple Level Lumbar Canal Stenosis: A Series of 583 Cases

Superior outcomes of decompression with an interlaminar dynamic device versus decompression alone in patients with lumbar spinal stenosis and back pain: a cross registry study

Optimal Cut-Off Value of the Superior Articular Process Area as a Morphological Parameter to Predict Lumbar Foraminal Stenosis

Contact Info

Product

Resources

About