Postlaminectomy Adhesion of the Cauda Equina

Nakano, Masato; Matsui, Hisao; Miaki, Kentaro; Yamagami, Tohru; Tsuji, Haruo

doi:10.1097/00007632-199705150-00010

Cited by 13 publications

(4 citation statements)

References 34 publications

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“…We decompressed the lamina to relieve dural compression in the first surgery, while laminectomy was performed to increase the vascular permeability of the cauda equina. This increased permeability has been associated with cauda equina adhesion in rats [ 15 ]. In other study, foreign material retention accelerated arachnoiditis and peridural fibrosis post-laminectomy [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

Delayed symptomatic spinal adhesive arachnoiditis after surgery for thoracolumbar flexion-distraction injury: A case report

Lim

Sohn

2020

International Journal of Surgery Case Reports

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Section: Discussionmentioning

confidence: 99%

Delayed symptomatic spinal adhesive arachnoiditis after surgery for thoracolumbar flexion-distraction injury: A case report

Lim

Sohn

2020

International Journal of Surgery Case Reports

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“…Songer [ 7 ] proposed the three-dimensional theory, as they considered that the musculus sacrospinalis damage, fiber ring, and longitudinal ligament injury were the common sources of epidural scar formation. Nakano [ 8 ] found that damage to the nerve-blood barrier caused changes in vascular permeability, which was the most important cause of cauda equina adhesion. They proposed that the trauma caused by lamina excision induces the tight junction between endothelial cells to become loose, which increases vascular permeability in cauda equina nerve roots through a series of pathological changes, causing nerve adhesion.…”

Section: Discussionmentioning

confidence: 99%

Clinical Use of a New Nano-Hydroxyapatite/Polyamide66 Composite Artificial Lamina in Spinal Decompression Surgery: More Than 4 Years’ Follow-Up

et al. 2018

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BackgroundLong-term follow-up results showed that epidural scar formation and adhesion after laminectomy always affected the outcomes of repeat operations. The establishment of a barrier between scar tissue and dura was effective in preventing epidural scar formation.Material/MethodsA nano-hydroxyapatite/polyamide66 (n-HA/PA66) artificial lamina was designed and fabricated and used to cover the opened spinal canal in patients who received laminectomy. The visual analogue scale (VAS) and Japanese Orthopedic Association (JOA) Scores, X-ray, computed tomography, and magnetic resonance imaging results were periodically recorded and evaluated.ResultsAll patients were followed up for 4–7 years, with an average period of 5.2 years. The clinical symptoms improved significantly after surgery, as the JOA scores were significantly improved after the operation and maintained to last follow-up when compared with preoperative ones (P<0.05). The vertebral canal became noticeably enlarged, from 16.7±4.7 mm to 32.9±2.2 mm, after surgery and well maintained to 32.1±1.8 mm. The lumbar lordosis was well maintained after surgery. No rupture, absorption, or dislodgement of the n-HA/PA66 lamina was found. MRI showed the spinal canal had the correct morphology, with no stenosis, no obvious scar formation, and no nerve roots or epidural sac compression.ConclusionsThe artificial lamina is a reasonable choice for prevention of epidural scar formation after laminectomy, in spite of the results from a small sample of cases.

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“…Matsui et al [4] examined the time-related changes seen on postoperative MRI scans after lumbar laminectomy in 10 patients and they reported that cauda equina adhesions and shrinkage of the thecal sac were closely correlated with laminectomy. Their group also evaluated the vascular permeability changes of the cauda equina after lumbar laminectomy in rats and they speculated that accelerated permeability may enhance cauda equina adhesions [5]. But this mechanism has not yet been clinically clarified.…”

Section: Discussionmentioning

confidence: 99%

MRI Changes of the Spinal Subdural Space after Lumbar Spine Surgeries: Report of Two Cases

et al. 2011

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Although magnetic resonance imaging (MRI) is frequently used to assess the lumbar spine, there are few reports in the medical literature that have evaluated using MRI immediately following spinal surgery. Furthermore, descriptions of the subdural changes after lumbar spine surgery are also infrequent. In this paper, we present two cases with subdural change seen on MRI immediately after lumbar surgery. Both the patients had mild symptoms that resolved spontaneously, and the follow-up MRI scans showed resolution of the subdural changes. Subdural changes should be considered as one of the possible causes of unexpected symptoms in patients following lumbar spinal surgery.

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Postlaminectomy Adhesion of the Cauda Equina

Cited by 13 publications

References 34 publications

Delayed symptomatic spinal adhesive arachnoiditis after surgery for thoracolumbar flexion-distraction injury: A case report

Delayed symptomatic spinal adhesive arachnoiditis after surgery for thoracolumbar flexion-distraction injury: A case report

Clinical Use of a New Nano-Hydroxyapatite/Polyamide66 Composite Artificial Lamina in Spinal Decompression Surgery: More Than 4 Years’ Follow-Up

MRI Changes of the Spinal Subdural Space after Lumbar Spine Surgeries: Report of Two Cases

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