The association between spondylolisthesis and decreased muscle health throughout the lumbar spine for patients with operative lumbar spinal stenosis

Object Although many cases of primary intraspinal facet cysts in the lumbar spine have been reported, there have only been a few reports of postoperative intraspinal facet cysts in the lumbar spine. The purpose of this study was to investigate the prevalence and clinical features of postoperative intraspinal facet cysts in the lumbar spine. Methods Data from 81 patients undergoing microendoscopic posterior decompression to treat lumbar spinal stenosis were reviewed. The development of a postoperative intraspinal facet cyst was observed using MR imaging during 1 year after surgery. If the patient demonstrated a postoperative intraspinal facet cyst, additional MR imaging was performed to evaluate the natural course of the cyst. Furthermore, the authors conducted a comparative evaluation to identify the factors associated with the causes of cyst development. Results A postoperative intraspinal facet cyst developed in 7 patients (8.6%) during 1 year after surgery. Spondylotic spinal stenosis, degenerative spondylolisthesis, and degenerative scoliosis were revealed before surgery in 2, 4, and 1 patient, respectively. In 5 patients, the cysts developed within 3 months after surgery. Although 3 patients exhibited symptoms caused by cyst development, all symptoms were relieved by conservative treatment. On radiographic evaluations, postoperative segmental spinal instability, including a progression of spondylolisthesis and disc degeneration, was revealed in 6 (86%) of the 7 patients. Spontaneous regression of the cysts was observed in 5 (71%) of these 7 patients. On comparative evaluation of patients with and without postoperative intraspinal facet cysts, the presence of segmental spinal instability before surgery (including degenerative spondylolisthesis) and the appearance of postoperative segmental spinal instability were related to the development of the cysts. Conclusions The prevalence of postoperative intraspinal facet cysts, including asymptomatic cysts, was 8.6% during 1 year after decompression surgery for lumbar spinal stenosis. The development of postoperative intraspinal facet cysts was related to the presence of segmental spinal instability before surgery (including degenerative spondylolisthesis) and postoperative segmental spinal instability, including a progression of spondylolisthesis and disc degeneration after surgery. A postoperative intraspinal facet cyst, which can be expected to regress spontaneously with a probability > 50%, should be recognized as one of the postoperative complications of decompression surgery for lumbar spinal stenosis.

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Facet Tropism and Orientation: Risk Factors for Degenerative Lumbar Spinal Stenosis

BioMed Research International ◽

10.1155/2020/2453503 ◽

2020 ◽

Vol 2020 ◽

pp. 1-6

Author(s):

Janan Abbas ◽

Natan Peled ◽

Israel Hershkovitz ◽

Kamal Hamoud

Keyword(s):

Risk Factors ◽

Lumbar Spine ◽

Spinal Stenosis ◽

Lumbar Spinal Stenosis ◽

Control Group ◽

Degenerative Lumbar Spinal Stenosis ◽

Lower Lumbar Spine ◽

Lumbar Spinal ◽

Lower Lumbar ◽

Facet Tropism

The aim of this study is to establish whether facet tropism (FT) and orientation (FO) are associated with degenerative lumbar spinal stenosis (DLSS). A retrospective computerized tomography (CT) study including 274 individuals was divided into two groups: control (82 males and 81 females) and stenosis (59 males and 52 females). All participants have undergone high-resolution CT scan of the lumbar spine in the same position. FT and FO were measured at L1-2 to L5-S1. Significant sagittal FO was noted in the stenosis males (L2-3 to L4-5) and females (L2-3 to L5-S1) compared to the controls. The prevalence of FT was remarkably greater in the stenosis males (L4-5, L5-S1) and females (L3-4, L5-S1) compared to their counterparts in the control group. Our results also showed that FT (L3-4 to L5-S1) increases approximately 2.9 times the likelihood for DLSS development. This study indicates that FO and FT in the lower lumbar spine are significantly associated with DLSS.

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Topping Phenomenon with Recurrent Spinal Stenosis and Epidural Fibrosis Prevented with Oxidized Cellulose – a Case Report

Acta Medica (Hradec Kralove Czech Republic) ◽

10.14712/18059694.2018.55 ◽

2018 ◽

Vol 61 (2) ◽

pp. 69-73 ◽

Cited By ~ 2

Author(s):

Radek Hart

Keyword(s):

Case Report ◽

Lumbar Spine ◽

Spinal Stenosis ◽

Lumbar Spinal Stenosis ◽

Oxidized Cellulose ◽

Epidural Fibrosis ◽

Nerve Roots ◽

Failed Back Syndrome ◽

Dural Sac ◽

Lumbar Spinal

Lumbar spinal stenosis is a condition where the neural structures are compressed in the narrowed spinal canal and often situated only within a single specific segment of the spine, most frequently in the lumbar spine. A case report demonstrates a surgical solution of lumbar spinal stenosis with using oxidized cellulose as a prevention of post-operative adhesions and failed back syndrome. A female patient (68) with a significant pain of the lumbar spine lasting for a number of months due to advanced spondylosis, failing to respond to conservative treatment underwent instrumented, posterolateral fusion of affected segments. The patient re-arrived with pain due to spinal stenosis in another segments after 4 and then after 3 years. We repeatedly performed spinal fusion of the affected segments and applied an antiadhesive gel to the dural sac and the decompressed nerve roots to prevent the development of post-operative adhesions and the “failed back syndrome”. Last surgical solution included mobilisation of the simultaneously constricted dural sac through laminectomy. This time we covered the sac using a haemostat made of oxidized cellulose (Traumacel FAM). After this treatment, the patient was again without significant difficulties.

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Degenerative lumbar spinal stenosis: analysis of results in a series of 374 patients treated with unilateral laminotomy for bilateral microdecompression

Journal of Neurosurgery Spine ◽

10.3171/spi-07/12/579 ◽

2007 ◽

Vol 7 (6) ◽

pp. 579-586 ◽

Cited By ~ 92

Author(s):

Francesco Costa ◽

Marco Sassi ◽

Andrea Cardia ◽

Alessandro Ortolina ◽

Antonio De Santis ◽

...

Keyword(s):

Lumbar Spine ◽

Surgical Technique ◽

Spinal Stenosis ◽

Lumbar Spinal Stenosis ◽

Consecutive Series ◽

Degenerative Lumbar Spinal Stenosis ◽

Neurological Improvement ◽

Minimally Invasive Surgical ◽

Lumbar Spinal

Object Surgical decompression is the recommended treatment in patients with moderate to severe degenerative lumbar spinal stenosis (DLSS) in whom symptoms do not respond to conservative therapy. Multilevel disease, poor patient health, and advanced age are generally considered predictors of a poor outcome after surgery, essentially because of a surgical technique that has always been considered invasive and prone to causing postoperative instability. The authors present a minimally invasive surgical technique performed using a unilateral approach for lumbar decompression. Methods A retrospective study was conducted of data obtained in a consecutive series of 473 patients treated with unilateral microdecompression for DLSS over a 5-year period (2000–2004). Clinical outcome was measured using the Prolo Economic and Functional Scale and the visual analog scale (VAS). Radiological follow-up included dynamic x-ray films of the lumbar spine and, in some cases, computed tomography scans. Results Follow-up was completed in 374 (79.1%) of 473 patients—183 men and 191 women. A total of 520 levels were decompressed: 285 patients (76.2%) presented with single-level stenosis, 86 (22.9%) with two-level stenosis, and three (0.9%) with three-level stenosis. Three hundred twenty-nine patients (87.9%) experienced a clinical benefit, which was defined as neurological improvement in VAS and Prolo Scale scores. Only three patients (0.8%) reported suffering segmental instability at a treated level, but none required surgical stabilization, and all were successfully treated conservatively. Conclusions Evaluation of the results indicates that unilateral microdecompression of the lumbar spine offers a significant improvement for patients with DLSS, with a lower rate of complications.

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Results of surgical treatment of degenerative stenosis of the lumbar spine in elderly and old patients

Health care of Tajikistan ◽

10.52888/0514-2515-2021-349-2-81-84 ◽

2021 ◽

pp. 81-85

Author(s):

H. J. Rahmonov ◽

R. N. Berdiev ◽

I. M. Rizoev ◽

N. O. Rakhimov

Keyword(s):

Surgical Treatment ◽

Lumbar Spine ◽

Spinal Stenosis ◽

Lumbar Spinal Stenosis ◽

Older Patients ◽

Neurological Status ◽

Old Patients ◽

Canal Stenosis ◽

Microsurgical Decompression ◽

Lumbar Spinal

Aim. To evaluate the results of surgical treatment in older patients with lumbar spinal stenosis.Materials and methods. The study is based on the results of a comprehensive examination and surgical treatment of 20 patients who were hospitalized in the neurosurgery department of the SI NMC “Shifobakhsh” in the Department of Neurosurgery and Combined Trauma of the ATSMU with stenosis of the lumbar spine with various options for the clinical course. Assessment of the neurological status in degenerative spinal disease was conducted using a visual analog scale (VAS.)Results. When comparing subgroups, it was noted that decompressive interventions show the best results for lumbar spinal stenosis in the older age group.Conclusion. The use of differentiated microsurgical decompression techniques in older patients with degenerative lateral and central spinal canal stenosis provides an improvement in quality of life.

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