Results After Lumbar Decompression With and Without Discectomy

Jayarao, Mayur; Chin, Lawrence S.

doi:10.1227/01.neu.0000365826.15986.40

Cited by 11 publications

(20 citation statements)

References 47 publications

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“…The first therapeutic approach should always be the conservative treatment and our study included only patients that had undergone conservative treatment, but failed to show adequate response. This is however consistent with other recent randomized controlled studies have shown greater improvements in patients after surgery than after conservative treatment [12] [14]. A recent systematic review comparing surgery to conservative treatment in LSS suggested that for patients with radicular pain caused by LSS, in whom a trial of 3 -6 months of conservative treatment had failed, surgery did not improve walking ability but improved pain, function than continuing conservative treatment [10].…”

Section: Discussionsupporting

confidence: 87%

“…A recent systematic review comparing surgery to conservative treatment in LSS suggested that for patients with radicular pain caused by LSS, in whom a trial of 3 -6 months of conservative treatment had failed, surgery did not improve walking ability but improved pain, function than continuing conservative treatment [10]. Small improvements are generally reported by patients treated conservatively and serious complications or deterioration are rare with conservative treatment [1]- [12] [14].…”

Section: Discussionmentioning

confidence: 99%

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Techniques of Surgery for Lumbar Spinal Stenosis: A Comparative Study

Hawis¹,

Iacob²

2019

OJMN

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Techniques of Surgery for Lumbar Spinal Stenosis: A Comparative Study

Hawis¹,

Iacob²

2019

OJMN

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“…The first therapeutic approach should always be the conservative treatment and our study included only patients that had undergone conservative treatment, but failed to show adequate response. This is however consistent with other recent randomized controlled studies have shown greater improvements in patients after surgery than after conservative treatment [12,14]. A recent systematic review comparing surgery to conservative treatment in LSS suggested that for patients with radicular pain caused by LSS, in whom a trial of 3-6 months of conservative treatment had failed, surgery did not improve walking ability but improved pain, function than continuing conservative treatment [10].…”

Section: Discussionsupporting

confidence: 86%

“…with a small radius of curvature scoliosis and a big radius of curvature installed in adolescence a big radius of curvature, with rapid evolution 5-100 in one year generating both radiculalgia and instability  scoliosis with rotation and rapid evolution to 30-500 affecting several levels  combined stenosis and facet joint cyst  LSS with severe polineuropaty, with or without uni/bilateral paresis The pathophysiology of spinal stenosis causing neurologic symptoms is likely from a combination of anatomic compression of nerve roots as well as impaired blood flow primarily to the nerve roots [1,2,5,6,[10][11][12][13].…”

Section: Discussionmentioning

confidence: 99%

“…To solve such condition, the surgical treatment is not only a solution for resistant symptoms in patients with LSS, but really makes sense: in cases of consistent clinical and radiological findings after adequate conservative therapeutic measures have failed for a time at least three months span of control, to patients with realistic expectations; certified although by few evidence-based insights into the treatment options [1][2][3]6,7,[10][11][12][13][14]20,21] There are several points to consider into the preoperative planning: medical status & physiologic age of the patient, clinical and morphologic aspects, comorbidities, if LSS is symptomatic.…”

Section: Discussionmentioning

confidence: 99%

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Techniques of Surgery for Lumbar Spinal Stenosis: A comparative study

Iacob¹,

Salam²,

Hawis³

2018

Romanian Neurosurgery

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Aim: To compare between classic open surgeries and minimally invasive surgeries in Lumbar Spinal Stenosis. Methods: A comparative descriptive study, involved 117 patients suffering from lumbar canal stenosis, aged between 40-70 years; admitted to department of Neurosurgery from March 2011 till august 2016 in King Fahad Hospital in Saudi Arabia. Study groups are consisted of group A as patients managed with classical laminectomy, group B as patients managed with Endoscopic spinal procedures and group C as patients managed with Microscopic decompression facilitated by the Metrex Tubular System. SPSS was used in data entry and analysis, and ethical considerations taken into consideration and participants filled the required inform consents. Results: Age of particaoncet ranged from 45 - 63 Year, Mean +/- 50. The degenerative canal stenosis with acute disc single level (cauda equina syndrome) was the most common type of lumbar canal stenosis encountered in group A, the unilateral foraminal and lateral recess stenosis without disc prolapse was the most common type of lumbar canal stenosis encountered in group B, while The unilateral foraminal and lateral recess stenosis without disc prolapse was the most common type of lumbar canal stenosis encountered in group C. Classic laminectomy and disectomy used mostly in group A, endoscopic unilateral decompression lamino-foraminotomy without discectomy used mostly in group B and bilateral microscopic laminectomy without discectomy followed by unilateral microscopic lamino-foraminotomy without discectomy used mostly in group C. Mean of operation duration was the highest in both gender of group A, followed by group B, then group C. Unintended durotomy was the most common intra operative complications occurred in the whole study especially in group A. Mean of blood lost was the highest in both gender of group A, followed by group B, then group C. Postop complications in the patients of study Groups was the highest in group A (33.3 %) ,followed by group B (8.5 %) and then group C (2 %). Conclusion: Microscopic decompression facilitated by the Metrex Tubular System is the most effective techniques of Surgery for Lumbar Spinal Stenosis and the least intraoperative and post-operative complications.

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Unilateral laminotomy with bilateral spinal canal decompression: systematic review of outcomes and complications

Algarni,

Al-Amoodi,

Marwan

et al. 2023

BMC Musculoskelet Disord

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Background Unilateral laminotomy with bilateral spinal canal decompression has gained popularity recently. Aim To systematically review the literature of unilateral laminotomy with bilateral spinal canal decompression for lumbar spinal stenosis (LSS) aiming to assess outcomes and complications of the different techniques described in literature. Methods On August 7, 2022, Pubmed and EMBASE were searched by 2 reviewers independently, and all the relevant studies published up to date were considered based on predetermined inclusion and exclusion criteria. The subject headings “unilateral laminotomy”, “bilateral decompression” and their related key terms were used. The Preferred Reporting Item for Systematic Reviews and Meta-Analyses statement was used to screen the articles. Results A total of seven studies including 371 patients were included. The mean age of the patients was 69.0 years (range: 55–83 years). The follow up duration ranged from 1 to 3 years. Rate of postoperative pain and functional improvement was favorable based on VAS, JOA, JOABPEQ, RMDW, ODI and SF-36, for example improved from a range of 4.2–7.5 preoperatively on the VAS score to a range of 1.4–3.0 postoperatively at the final follow up. Insufficient decompression was noted in 3% of the reported cases. The overall complication rate was reported at 18–20%, with dural tear at 3.6–9% and hematoma at 0–4%. Conclusion Unilateral laminotomy with bilateral decompression has favorable short- and mid-term pain and functional outcomes with low recurrence and complication rates. This, however, needs to be further confirmed in larger, long-term follow-up, prospective, comparative studies between open, and minimally invasive techniques.

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Results After Lumbar Decompression With and Without Discectomy

Cited by 11 publications

References 47 publications

Techniques of Surgery for Lumbar Spinal Stenosis: A Comparative Study

Techniques of Surgery for Lumbar Spinal Stenosis: A Comparative Study

Techniques of Surgery for Lumbar Spinal Stenosis: A comparative study

Unilateral laminotomy with bilateral spinal canal decompression: systematic review of outcomes and complications

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