Multi-segmental lumbar spinal stenosis treated with Dynesys stabilization versus lumbar fusion in elderly patients: a retrospective study with a minimum of 5 years’ follow-up

Background and Objective Lumbar spinal stenosis (LSS) is a common degenerative condition that occurs in the spine with increasing age. Clinically, LSS causes a progressive reduction in walking autonomy, resulting in a poor quality of life and impaired functional capacity. The aim of this study was to evaluate the clinical outcome and quality of life of elderly patients presenting with LSS and associated comorbidities after a 5-year follow-up who were treated with an interspinous process device (IPD). Material and Methods Sixty patients > 75 years of age presenting with symptomatic degenerative LSS were included. All were treated with an IPD under local anesthesia. American Society of Anesthesiology score, Zurich Claudication Questionnaire, and Short Form 36 were evaluated pre- and postoperatively and at the follow-up visit each year for 5 years. Results The mean surgery time while under local anesthesia was 20 minutes. Forty-eight patients were followed for 5 years. Significant clinical improvements in all outcome scores (p < 0.05) both postoperatively or at follow-up were found. Conclusions IPD seems to be an effective and safe treatment for LSS in elderly patients with general comorbidities. In our study, all followed up patients had a meaningful improvement of their quality of life even at 5 years after surgery.

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Clinical and radiographic outcomes for microsurgical unilateral laminotomy for bilateral decompression of lumbar spinal stenosis for elderly patients-A retrospective cohort study

10.21203/rs.3.rs-23512/v1 ◽

2020 ◽

Author(s):

Bin Lv

Keyword(s):

Elderly Patients ◽

Spinal Stenosis ◽

Lumbar Spinal Stenosis ◽

Short Form ◽

Short Form Health Survey ◽

Radiographic Outcomes ◽

Form Health ◽

Lumbar Spinal ◽

Short Form Health

Abstract BackgroundRecently, unilateral laminotomy for bilateral decompression (ULBD) has become a alternative to conventional decompression for symptomatic lumbar spinal stenosis (LSS),and this minimally invasive surgical technique has shown a satisfactory outcomes and low complications. However, the influence of old age on the risk of postoperative complications and clinical outcome is not well understood.OBJECTIVEThe purpose of this study was to evaluate clinical and radiographic outcomes and complication rates after ULBD in elderly patients.Study DesignSingle center retrospective observational study.SettingAll data was from the affiliated people's hospital of Jiangsu University.METHODSIn this study, 39 elderly patients were treated for lumbar spinal stenosis by ULBD between January 2016 and January 2018. Follow-up consisted of radiologic investigations, Visual Analog Scale, Oswestry Disability Index, and 36-Item Short-Form Health Survey at 6 and 12 months postoperatively. Preoperative comorbidity, postoperative complications and revision surgery rates were also analyzed.RESULTSThere were 12 female patients and 27 male patients with a mean age of 75.83 ± 9.16 years. 20 patients had one levels of spinal stenosis, 13 patients had two levels of stenosis, 6 patients had three levels of stenosis. Average follow-up time was 14.6 ± 7.8 months (range, 6–24 months), Total complications were 10.2%(4/39),and reoperation rate was 2.5%(1/39). Oswestry Disability Index scores decreased significantly (from 32.26 ± 6.82 to 11.44 ± 2.50 at 6 months and 10.56 ± 2.29 at 12 months), and 36-Item Short-Form Health Survey parameter scores demonstrated a significant improvement in the follow-up results.LimitationA multi-center study is recommended to confirm our findings and explore the factors related to clinical and radiographic outcomes.CONCLUSIONSULBD for lumbar spinal stenosis is a safe and effective treatment for elderly patients, improves these patients’ quality of life and does not pose an increased risk of complications.

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The Therapeutic Evaluation of Spinal Canal Decompression by Using the TBEIS Technique in the Treatment of Lumbar Spinal Stenosis

BioMed Research International ◽

10.1155/2020/6183027 ◽

2020 ◽

Vol 2020 ◽

pp. 1-9

Author(s):

Kemin You ◽

Bo Li ◽

Hongze Chang ◽

Yan Zhang ◽

Feng Cai ◽

...

Keyword(s):

Elderly Patients ◽

Spinal Stenosis ◽

Lumbar Spinal Stenosis ◽

Clinical Efficacy ◽

The Elderly ◽

Clinical Effects ◽

Vas Scores ◽

Immediate Surgery ◽

Lumbar Spinal

Objective. To evaluate the clinical efficacy of the percutaneous endoscopic Transforaminal Broad Easy Immediate Surgery (TBEIS) technology in elderly patients with lumbar spinal stenosis (LSS). Methods. From February 2016 to May 2018, 35 elderly patients with LSS were treated with the TBEIS technique. There were 23 males and 12 females, aged from 53 to 72 years with a median age of 63.1 years. Preoperative, 1 day, and 1 and 12 months postoperative visual analogue scale (VAS) scores and Oswestry Disability Index (ODI) were statistically analyzed. The modified MacNab criterion was used to assess the clinical effects. The radiological outcomes were evaluated by X-ray and computed tomography (CT). Results. All of the operations were successful. The operative time ranged from 120 to 170 min with a median time of 148 min. All of the patients were followed up for 12 to 38 months with a median follow-up of 18 months. Preoperative, 1 day, and 1 and 12 months postoperative VAS leg scores were 6.91±0.98, 1.69±0.68, 1.23±0.59, and 0.91±0.61, respectively, and the VAS back scores improved from 4.51±0.82 to 0.66±0.68. The ODI scores were 63.82±7.59, 38.79±6.36, 24.79±3.90, and 11.33±3.92, respectively. Postoperative scores of VAS and ODI were obviously improved (P<0.01). According to the modified MacNab criteria used to evaluate the clinical effects, 11 cases achieved excellent results, 18 cases achieved good results, 4 cases achieved fair results, and 2 cases achieved poor results. There were no neurovascular injury and other complications. Conclusions. Treatment of LSS in the elderly patients by the TBEIS technology has good clinical efficacy, and the technique is safe and minimally invasive.

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Effects of Wonli Acupuncture Procedure in Patients with LSS: A Clinical, Retrospective Study

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2014/212098 ◽

2014 ◽

Vol 2014 ◽

pp. 1-9 ◽

Cited By ~ 6

Author(s):

Geon-Mok Lee ◽

Eun-Yong Lee ◽

Jong-Hyun Han ◽

Kyong-Ha Cho ◽

Se-Rin Kang ◽

...

Keyword(s):

Retrospective Study ◽

Life Span ◽

Spinal Stenosis ◽

Lumbar Spinal Stenosis ◽

Intervertebral Foramen ◽

Average Life ◽

Exclusion Criteria ◽

Average Life Span ◽

Lumbar Spinal

Background. Lumbar spinal stenosis (LSS) is a disease with increasing prevalence due to prolongation of average life span. Despite various treatment methods, many limitations remain unsolved.Objective. We are reporting cases of patients who have been treated with Wonli Acupuncture, a method of treating LSS by directly approaching the intervertebral foramen and interlaminar space with acupuncture needles different from those used in original acupuncture.Methods. A total of 82 patients with LSS were treated with Wonli Acupuncture, and out of those, 47 patients without exclusion criteria were selected for the following research. We compared the pretreatment VAS and ODI scores based on 1-year follow-up measurements.Results. The ODI value dropped by15.3±24.8on average (from35.2±19.9at the baseline to19.8±20.6at the reading)P<0.01and the average VAS also dropped by19.2±37.2(from60.7±23.1at baseline to41.5±31.9at the reading)P<0.01.Conclusions. Wonli Acupuncture was found to have clinical efficacy for lumbar spinal stenosis.

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Gait analysis in the elderly patients with lumbar spinal stenosis

International Orthopaedics ◽

10.1007/s00264-020-04935-w ◽

2021 ◽

Vol 45 (3) ◽

pp. 673-679

Author(s):

Yong-Gang Li ◽

Li-Ping Li ◽

Zhen-Jiang Li ◽

Hui Li ◽

Yuan Li ◽

...

Keyword(s):

Elderly Patients ◽

Gait Analysis ◽

Spinal Stenosis ◽

Lumbar Spinal Stenosis ◽

The Elderly ◽

Lumbar Spinal

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Mean five years follow up results of a facet replacement device in the treatment of lumbar spinal stenosis and degenerative spondylolisthesis

World Neurosurgery ◽

10.1016/j.wneu.2021.06.045 ◽

2021 ◽

Author(s):

Shahnawaz Haleem ◽

Awaiz Ahmed ◽

Satish Ganesan ◽

Stephen F. McGillion ◽

John L. Fowler

Keyword(s):

Spinal Stenosis ◽

Lumbar Spinal Stenosis ◽

Degenerative Spondylolisthesis ◽

Lumbar Spinal ◽

Replacement Device

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Linical efficacy of percutaneous endoscopic lumbar discectomy for the treatment of lumbar spinal stenosis in elderly patients: a retrospective study

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-020-01968-0 ◽

2020 ◽

Vol 15 (1) ◽

Author(s):

Hua Li ◽

Yufu Ou ◽

Furong Xie ◽

Weiguo Liang ◽

Gang Tian ◽

...

Keyword(s):

Elderly Patients ◽

Spinal Stenosis ◽

Lumbar Spinal Stenosis ◽

Lumbar Discectomy ◽

Lumbar Spine Surgery ◽

Decompression Surgery ◽

Percutaneous Endoscopic Lumbar Discectomy ◽

Pain Scores ◽

Endoscopic Lumbar Discectomy ◽

Lumbar Spinal

Abstract Background Although percutaneous endoscopic lumbar discectomy (PELD) is increasingly being used to treat lumbar degenerative disease, the treatment of elderly patients with lumbar spinal stenosis (LSS) involves considerable uncertainty. The purpose of this study was to evaluate the safety and effectiveness of PELD for the treatment of LSS in elderly patients aged 65 years or older. Methods In this retrospective review, 136 patients aged 65 years or older who underwent PELD to treat LSS were evaluated. The patients were divided into two groups, group A (ages 65–74) and group B (age ≥ 75), and perioperative data were analyzed. The Japanese Orthopaedic Association (JOA) score, visual analog scale (VAS) score, and MacNab classification were used to evaluate postoperative clinical efficacy. Results All patients successfully underwent the operation with satisfactory treatment outcomes. Compared to preoperative scores, the self-reported scores or pain while performing daily activities were significantly improved in both treatment groups (P < 0.05). No statistically significant between-group differences were observed in operation time, intraoperative blood loss, postoperative bed rest, and postoperative hospital stay (P > 0.05). The overall postoperative complication rate was similar between the two groups. Moreover, no statistically significant differences in VAS-back pain scores, VAS-leg pain scores, JOA scores, and MacNab classification were found between the groups at the 3-month and 1.5-year follow-up examinations (P > 0.05). Conclusion PELD is safe and effective for the treatment of LSS in elderly patients. Age is not a contraindication for decompressive lumbar spine surgery. PELD has advantages such as reduced trauma, fewer anesthesia-related complications, and a fast postoperative recovery. Elderly patients should be considered good candidates for lumbar decompression surgery using minimally invasive techniques.

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A long-term (4- to 12-year) follow-up study of surgical treatment of lumbar spinal stenosis

European Spine Journal ◽

10.1007/s005860000161 ◽

2000 ◽

Vol 9 (6) ◽

pp. 563-570 ◽

Cited By ~ 43

Author(s):

M. Cornefjord ◽

G. Byröd ◽

H. Brisby ◽

B. Rydevik

Keyword(s):

Surgical Treatment ◽

Spinal Stenosis ◽

Lumbar Spinal Stenosis ◽

Follow Up Study ◽

Lumbar Spinal

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Improvement of Back and Leg Pain after Lumbar Spinal Decompression without Fusion

Journal of Neurological Surgery Part A Central European Neurosurgery ◽

10.1055/s-0038-1669473 ◽

2018 ◽

Vol 80 (02) ◽

pp. 081-087

Author(s):

Nicola Bongartz ◽

Christian Blume ◽

Hans Clusmann ◽

Christian Müller ◽

Matthias Geiger

Keyword(s):

Back Pain ◽

Spinal Stenosis ◽

Lumbar Spinal Stenosis ◽

Leg Pain ◽

Short Term ◽

Clear Trend ◽

Long Term Follow Up ◽

Lumbar Spinal

Background To evaluate whether decompression in lumbar spinal stenosis without fusion leads to sufficient improvement of back pain and leg pain and whether re-decompression alone is sufficient for recurrent lumbar spinal stenosis for patients without signs of instability. Material and Methods A successive series of 102 patients with lumbar spinal stenosis (with and without previous lumbar surgery) were treated with decompression alone during a 3-year period. Data on pre- and postoperative back pain and leg pain (numerical rating scale [NRS] scale) were retrospectively collected from questionnaires with a return rate of 65% (n = 66). The complete cohort as well as patients with first-time surgery and re-decompression were analyzed separately. Patients were dichotomized to short-term follow-up (< 100 weeks) and long-term follow-up (> 100 weeks) postsurgery. Results Overall, both back pain (NRS 4.59 postoperative versus 7.89 preoperative; p < 0.0001) and leg pain (NRS 4.09 versus 6.75; p < 0.0001) improved postoperatively. The short-term follow-up subgroup (50%, n = 33) showed a significant reduction in back pain (NRS 4.0 versus 6.88; p < 0.0001) and leg pain (NRS 2.49 versus 6.91: p < 0.0001). Similar results could be observed for the long-term follow-up subgroup (50%, n = 33) with significantly less back pain (NRS 3.94 versus 7.0; p < 0.0001) and leg pain (visual analog scale 3.14 versus 5.39; p < 0.002) postoperatively. Patients with previous decompression surgery benefit significantly regarding back pain (NRS 4.82 versus 7.65; p < 0.0024), especially in the long-term follow-up subgroup (NRS 4.75 versus 7.67; p < 0.0148). There was also a clear trend in favor of leg pain in patients with previous surgery; however, it was not significant. Conclusions Decompression of lumbar spinal stenosis without fusion led to a significant and similar reduction of back pain and leg pain in a short-term and a long-term follow-up group. Patients without previous surgery benefited significantly better, whereas patients with previous decompression benefited regarding back pain, especially for long-term follow-up with a clear trend in favor of leg pain.

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