Semi-Circumferential Decompression: Microsurgical Total<i>en-bloc</i>Ligamentum Flavectomy to Treat Lumbar Spinal Stenosis with Grade I Degenerative Spondylolisthesis

Lee, Young Sang; Choi, Jun Cheol; Oh, Sang Hun; Park, Sub Ri; Park, Sang Jun; Cho, Nam Ik

doi:10.4055/cios.2015.7.4.470

Cited by 5 publications

(3 citation statements)

References 21 publications

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“…14-24 One study assessed laminoplasty, 17 and 1 study assessed semi-circumferential decompression. 25 In 5 of the fusion studies, patients underwent un-instrumented posterolateral fusion, 15,17,21,22,26 and in the remaining fusion studies, some form of interbody fusion was used. 19,27-33…”

Section: Methodsmentioning

confidence: 99%

Decompression Versus Fusion for Grade I Degenerative Spondylolisthesis: A Meta-Analysis

Koenig

Jauregui

Shasti

et al. 2018

Global Spine Journal

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Study Design: Meta-analysis of evidence level I to IV studies. Objective: To compare decompression alone versus decompression plus fusion in the treatment of grade I degenerative spondylolisthesis (DS). Methods: Following established guidelines, we systematically reviewed 3 electronic databases to assess studies evaluating patients with grade I DS. We stratified all patients into 2 cohorts; the first cohort underwent a decompression-type surgery, and the second cohort underwent decompression plus fusion. We noted clinical outcomes, complications, reoperations, and surgical details such as blood loss. Descriptive statistics and random-effects models were used to determine the specified outcome metrics with 95% confidence intervals (CIs). Results: In both cohorts, the pain (legs and lower back) significantly decreased and the physical component of the Short Form 36 showed better patient clinical outcomes. The decompression cohort had a 5.8% complication rate (95% CI = 1.7-2.1), and the decompression plus fusion cohort had an 8.3% complication rate (95% CI = 5.5-11.6). The reoperation rate was higher in the decompression-only cohort (8.5%; 95% CI = 2.9-17.0) compared with the decompression plus fusion cohort (4.9%; 95% CI = 2.5-7.9). Conclusions: There does not appear to be any advantage of one procedure over the other. Patients undergoing decompression alone tended to be older with a higher percentage of leg pain, whereas patients additionally undergoing fusion tended to be younger with more lower back pain. The decompression-only cohort had fewer complications but a higher revision rate.

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Section: Methodsmentioning

confidence: 99%

Decompression Versus Fusion for Grade I Degenerative Spondylolisthesis: A Meta-Analysis

Koenig

Jauregui

Shasti

et al. 2018

Global Spine Journal

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“…F F [45], which may result in a "more stable" decompression that could potentially decrease the incidence of postoperative instability and revision surgery. Several studies have reported about the clinical outcomes of microscopic, assisted decompression in low grade spondylolisthesis [23][24][25][26][44][45][46][47][48]. Following this technique, some reported no significant slip progression in short to midterm follow-up [24,26,47], while others reported significant slip progression [44,45].…”

Section: A a B B C C D D E Ementioning

confidence: 99%

“…Several studies have reported about the clinical outcomes of microscopic, assisted decompression in low grade spondylolisthesis [23][24][25][26][44][45][46][47][48]. Following this technique, some reported no significant slip progression in short to midterm follow-up [24,26,47], while others reported significant slip progression [44,45]. Minamide et al [44] reported significant clinical improvement while slip progression occurred in 19 of 242 cases (7.9%).…”

Section: A a B B C C D D E Ementioning

confidence: 99%

Outcomes of Microscopic-Assisted Decompression Surgery Without Instrumented Fixation in Patients With Spinal Canal Stenosis and First-Degree Degenerative Spondylolisthesis: A Prospective Case Series

Mahmoud,

Maniar

et al. 2023

J Minim Invasive Spine Surg Tech

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Objective: To describe the minimally invasive, microscopic-assisted over-the-top technique and report its clinical and radiological outcomes in cases of spinal canal stenosis and first-degree degenerative lumbar spondylolisthesis.Methods: Twenty-two patients with grade I degenerative spondylolisthesis and spinal canal stenosis who underwent microscopic decompression without fusion between April 2017 and December 2020 were included in the study. Results: The study population included 13 men and 9 women, with an average age of 66.7 years (range, 55–79 years) and a mean duration of symptoms of 14.8 ± 11.6 months. The mean follow-up was 49.3 months (range, 24–67 months). At the last follow-up, 13 patients were fully satisfied, 7 patients were partially satisfied, and 2 patients (9%) were not satisfied and required revision surgery with fusion. At the final follow-up, the mean leg pain numerical pain rating scale (NPRS), back pain NPRS, Oswestry Disability Index score, and Japanese Orthopaedic Association Back Pain Evaluation Questionnaire showed significant improvements in all patients, and no patients showed progression of the degree of spondylolisthesis.Conclusion: The minimally invasive, over-the-top technique using surgical microscopy is a viable option in cases with first-degree degenerative spondylolisthesis and predominantly stenosis symptoms.

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Role of Ligamentum Flavectomy in Lumbar Spinal Canal Stenosis

El-Hafez

El-Halawany

Mostafa

2020

Al-Azhar Medical Journal

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Background: Lumbar spinal canal stenosis (LSCS) is a degenerative condition in which changes in the discs, ligamentum flavum, and facet joints with aging cause narrowing of the spaces around the neurovascular structures of the spine. These changes lead to pain in the legs and back, as well as impaired ambulation and other disabilities. Objective: To provide an update review for determining the role of ligamentum flavectomy in lumbar spinal canal stenosis. Patients and methods: This study was carried out as an interventional prospective study on 23 patients with lumbar spinal canal stenosis from August 2018 till August 2019. Study was conducted in Orthopedic Surgery Departments, EL-Sayed Galal and EL-Haram specialized Hospitals and aimed at assessment of the role of ligamentum flavectomy in lumbar spinal canal stenosis. Results:The mean age was 50.5 ± 5.7 years ranging from 41 to 59 years. According to gender distribution, they were 13(56.5 %) males, and 10 (43.5%) females. The preoperative VAS ranged between 5-9 with mean 6.8 ±1.4. Six weeks after operation its range became 1-5 with mean 2.8 ±0.98. Twelve weeks later, the range was 1-3 with mean 1.7 ±0.7. The preoperative ODI ranged between 3-46 with mean 19.56 ±19.65. Six weeks later, the range between 1-18 with mean 7.3 ±7.26. At twelve weeks, the range was between 1-15 with mean 4.2 ± 8.86. At level L4/L5, ten patients (43.48%) have lumbar stenosis. At L3/L4 and L4/L5 levels seven patients (30.42%), and at L2/L3, L3/L4, L4/L5 levels six patients (26.1%) have stenosis. Conclusion:Ligamentum flavum hypertrophy is one of main causes of spinal canal stenosis so ligamentum flavectomy is an essential step in all surgical management of lumbar spinal canal stenosis for decompression of spinal canal.

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Semi-Circumferential Decompression: Microsurgical Totalen-blocLigamentum Flavectomy to Treat Lumbar Spinal Stenosis with Grade I Degenerative Spondylolisthesis

Cited by 5 publications

References 21 publications

Decompression Versus Fusion for Grade I Degenerative Spondylolisthesis: A Meta-Analysis

Decompression Versus Fusion for Grade I Degenerative Spondylolisthesis: A Meta-Analysis

Outcomes of Microscopic-Assisted Decompression Surgery Without Instrumented Fixation in Patients With Spinal Canal Stenosis and First-Degree Degenerative Spondylolisthesis: A Prospective Case Series

Role of Ligamentum Flavectomy in Lumbar Spinal Canal Stenosis

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