What interventions improve walking ability in neurogenic claudication with lumbar spinal stenosis? A systematic review

2014 ◽  
Vol 23 (6) ◽  
pp. 1282-1301 ◽  
Author(s):  
Carlo Ammendolia ◽  
Kent Stuber ◽  
Christy Tomkins-Lane ◽  
Michael Schneider ◽  
Y. Raja Rampersaud ◽  
...  
Keyword(s):  
Systematic Review ◽  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Neurogenic Claudication ◽  
Walking Ability ◽  
Lumbar Spinal

scholarly journals Quantification of walking ability in subjects with neurogenic claudication from lumbar spinal stenosis—a comparative study

2012 ◽  
Vol 12 (2) ◽  
pp. 101-109 ◽  
Author(s):  
James Rainville ◽  
Lisa A. Childs ◽  
Enrique B. Peña ◽  
Pradeep Suri ◽  
Janet C. Limke ◽  
...  
Keyword(s):  
Comparative Study ◽  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Neurogenic Claudication ◽  
Walking Ability ◽  
Lumbar Spinal

scholarly journals Effective of Fusion in the Treatment of Lumbar Spinal Stenosis：A Systematic Review Andmeta-Analysis

2021 ◽  
Author(s):  
Yang Yang ◽  
Shi-tian Tang ◽  
Qian Chen ◽  
fang chen
Keyword(s):  
Systematic Review ◽  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Major Complication ◽  
Primary Objective ◽  
Leg Pain ◽  
Walking Ability ◽  
Degenerative Lumbar Spinal Stenosis ◽  
Pain Scores ◽  
Lumbar Spinal

Abstract Objective: The debate on efficacy of fusion added to decompression for lumbar spinal stenosis (LSS) is ongoing. The primary objective of this systematic review is to compare the outcome after decompression with and without fusion in patients with lumbar spinal stenosis .Methods: A literature search was performed in the Web of Science, EMBASE, Pubmed,and Cochrane Libraryfrom January 1990 to May 2021.The information of screened studies included clinical outcomes, and secondary measures, then data synthesis and meta-analysis were progressed.Data analysis was conducted using the Review Manager 5.0 software.Results: 17 studies were included in the analysis involving 2947 patients in total. In the majority of studies, including seven RCTs and ten observational studies. The pooled data revealed that fusion was associated with signifificantly higher rates of back pain scores when compared with decompression alone in RCT subgroup(SMD=-0.42, 95% CI (–0.60, -0.23), Z=4.31 P<0.0001).However, fusion signifificantly increased the intraoperative blood loss, operative time and hospital stay. Both techniques had similar leg Pain scores , EQ-5D, walking ability，ODI，major complication,clinical satisfactions and reoperation rate.Conclusions: Our studies showed that the additional fusion in the management of LSS yielded no clinical improvements over decompression alone within a 1-year follow-up period. We suggested that the least invasive and least costly procedure, being decompression alone, is preferred in patients with degenerative lumbar spinal stenosis. The appropriate surgical protocol for LSS should be discussed further.

scholarly journals Prediction of walking ability following posterior decompression for lumbar spinal stenosis

2021 ◽  
Author(s):  
Suzanne McIlroy ◽  
Feroz Jadhakhan ◽  
David Bell ◽  
Alison Rushton
Keyword(s):  
Quality Of Life ◽  
Higher Education ◽  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Walking Distance ◽  
Walking Ability ◽  
Poor Outcome ◽  
Lumbar Spinal ◽  
Reduced Risk

Abstract Purpose Following surgery for lumbar spinal stenosis (LSS) up to 40% of people report persistent walking disability. This study aimed to identify pre-operative factors that are predictive of walking ability post-surgery for LSS. Methods An observational cohort study was conducted using data from the British Spine Registry (2017–2018) of adults (≥ 50 years) with LSS, who underwent ≤ 2 level posterior lumbar decompression. Patients receiving fixation or who had previous lumbar surgery were excluded. Walking ability was assessed by a single item on the Oswestry Disability Index and dichotomised into poor/good outcome. Multivariable regression models were performed. Results 14,485 patients were identified. Pre-operatively 30% patients reported poor walking ability, this decreased to 8% at 12 months follow-up. Predictors associated with poor walking ability at 12 months were: increasing age (≥ 75 years OR 1.54, 95% CI 1.07, 2.18), BMI ≥ 35 kg/m2 (OR 1.52, 95% CI 1.00, 2.30), severity of leg pain (OR 1.10, CI 95% 1.01, 1.21), disability (OR 1.01, 95% CI 1.01, 1.02) and quality of life (OR 0.72, 95% CI 0.56, 0.89). Pre-operative maximum walking distance (OR 1.10, 95% CI 1.05, 1.25) and higher education (OR 0.90, 95% CI 0.80, 0.96) were associated with reduced risk of poor walking ability at 12 months; p < 0.05. Depression, fear of movement and symptom duration were not associated with risk of poor outcome. Conclusion Older age, obesity, greater pre-operative pain and disability and lower quality of life are associated with risk of poor walking ability post-operatively. Greater pre-operative walking and higher education are associated with reduced risk of poor walking ability post-operatively. Patients should be counselled on their risk of poor outcome and considered for rehabilitation so that walking and surgical outcomes may be optimised.

scholarly journals Stuburo juosmeninės dalies kanalo stenozė: klinikinė anatomija, diagnostika (I dalis)

2003 ◽  
Vol 1 (4) ◽  
pp. 0-0
Author(s):  
Valentinas Uvarovas ◽  
Giedrius Kvederas ◽  
Igoris Šatkauskas
Keyword(s):  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Nerve Root ◽  
Cauda Equina ◽  
Neurogenic Claudication ◽  
Clinical Anatomy ◽  
Ageing Population ◽  
Imaging Studies ◽  
Pathologic Features ◽  
Lumbar Spinal

Valentinas Uvarovas, Giedrius Kvederas, Igoris ŠatkauskasVilniaus universiteto Ortopedijos, traumatologijos ir plastinės chirurgijos klinikaVilniaus greitosios pagalbos universitetinė ligoninėŠiltnamių g. 29, LT-2043 VilniusEl paštas: [email protected] Pasaulyje ženkliai auga pagyvenusių žmonių populiacija, kartu daugėja ligų, kuriomis dažniausiai sergama perkopus į antrą gyvenimo pusę. Viena iš tokių ligų yra stuburo kanalo stenozė, t. y. susiaurėjimas. Dažniausia stuburo kanalo stenozės priežastis yra su amžiumi progresuojantys stuburo degeneraciniai pokyčiai. Ne visada arklio uodegos ar nervų šaknelių spaudimas sukelia dirginimo simptomus, tačiau progresuojant patologiniams anatominiams ir fiziologiniams pokyčiams gali išryškėti klinika. Kartais rentgenologiniai duomenys neatspindi klinikos, todėl labai svarbu tiksliai įvertinti ligos simptomus, jų eigą bei rentgenologinius duomenis, kad būtų pasirinkta tinkama gydymo taktika. Prasminai žodžiai: stuburo kanalo stenozė, neurogeninė klaudikacija, nervinės šaknelės, arklio uodega Lumbar spinal stenosis: clinical anatomy, diagnostics Valentinas Uvarovas, Giedrius Kvederas, Igoris Šatkauskas Lumbar spinal stenosis remains one of the most frequently encountered clinical important degenerative spinal disorders in the ageing population. Spinal stenosis is a narrowing or stricture of the spinal canal. Cauda equina and nerve root compression are noted in many asymptomatic individuals. The spinal degenerative process associated with ageing leads to pathoanatomical and pathophysiological changes with occasional clinical consequences. With progressive degenerative changes and compression, spinal stenosis may become symptomatic, although the severity of the symptoms is not necessarily associated with the magnitude of the compression seen on imaging studies. A thorough understanding of the etiology, pathologic features and a correlation between the symptoms and the precise location of the thecal sac and nerve root are very important in evaluating the imaging studies and planning appropriate treatment. Keywords: lumbar spinal stenosis, neurogenic claudication, spinal nerve root, cauda equina

scholarly journals Outcome of Surgical Treatment of Degenerative Lumbar Spinal Stenosis.

2016 ◽  
Vol 14 (1) ◽  
pp. 25-28
Author(s):  
Bishnu Babu Thapa ◽  
Sushil Rana Magar ◽  
Pankaj Chand ◽  
Bachhu Ram KC
Keyword(s):  
Conservative Treatment ◽  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Leg Pain ◽  
Walking Distance ◽  
Neurogenic Claudication ◽  
Long Term Outcome ◽  
Degenerative Lumbar Spinal Stenosis ◽  
Vas Score ◽  
Lumbar Spinal

Introduction: Spinal stenosis mostly occur in lumbar spine and causes back pain, leg pain & neurogenic claudication. Although conservative treatment is mainstay, decompression with or without fusion (with or without instrumentation) can be considered in non-responsive cases. However, long term outcome of the surgery is controversial. The aim of our study was to analyze the outcome of surgery in lumbar spinal stenosis in terms of post-operative pain and claudication distance.Methods: A prospective analysis of patients who underwent decompression or decompression with fusion (with or without instrumentation), after failure of 3-6 months conservative treatment, for lumbar spinal stenosis were conducted. Only those who were operated and followed up for at least two years were included.Their preop and postop VAS score and walking distance compared.Results: Of 22 cases enrolled in this study, VAS score was improved in 21 patients and walking distance increased. Only one patient complained of increase in pain score at 24 months.Conclusion: Operative management is a good option for selected patients, 21 out of 22 have improved VAS and claudication distance in our study

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