Clinical and radiological outcomes of endoscopic foraminoplasty and decompression assisted with preoperative planning software for lumbar foraminal stenosis

2021 ◽  
Author(s):  
Changgui Shi ◽  
Bin Sun ◽  
Guoke Tang ◽  
Ning Xu ◽  
Hailong He ◽  
...  
Keyword(s):  
Preoperative Planning ◽  
Foraminal Stenosis ◽  
Lumbar Foraminal Stenosis ◽  
Planning Software

scholarly journals Value of 3D Preoperative Planning for Primary Total Hip Arthroplasty Based on Biplanar Weightbearing Radiographs

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Y. Knafo ◽  
F. Houfani ◽  
B. Zaharia ◽  
F. Egrise ◽  
I. Clerc-Urmès ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Preoperative Planning ◽  
Femoral Stem ◽  
Leg Length ◽  
Femoral Offset ◽  
Postoperative Result ◽  
Total Hip ◽  
Planning Software ◽  
Navigated Surgery

Two-dimensional (2D) planning on standard radiographs for total hip arthroplasty may not be sufficiently accurate to predict implant sizing or restore leg length and femoral offset, whereas 3D planning avoids magnification and projection errors. Furthermore, weightbearing measures are not available with computed tomography (CT) and leg length and offset are rarely checked postoperatively using any imaging modality. Navigation can usually achieve a surgical plan precisely, but the choice of that plan remains key, which is best guided by preoperative planning. The study objectives were therefore to (1) evaluate the accuracy of stem/cup size prediction using dedicated 3D planning software based on biplanar radiographic imaging under weightbearing and (2) compare the preplanned leg length and femoral offset with the postoperative result. This single-centre, single-surgeon prospective study consisted of a cohort of 33 patients operated on over 24 months. The routine clinical workflow consisted of preoperative biplanar weightbearing imaging, 3D surgical planning, navigated surgery to execute the plan, and postoperative biplanar imaging to verify the radiological outcomes in 3D weightbearing. 3D planning was performed with the dedicated hipEOS® planning software to determine stem and cup size and position, plus 3D anatomical and functional parameters, in particular variations in leg length and femoral offset. Component size planning accuracy was 94% (31/33) within one size for the femoral stem and 100% (33/33) within one size for the acetabular cup. There were no significant differences between planned versus implanted femoral stem size or planned versus measured changes in leg length or offset. Cup size did differ significantly, tending towards implanting one size larger when there was a difference. Biplanar radiographs plus hipEOS planning software showed good reliability for predicting implant size, leg length, and femoral offset and postoperatively provided a check on the navigated surgery. Compared to previous studies, the predictive results were better than 2D planning on conventional radiography and equal to 3D planning on CT images, with lower radiation dose, and in the weightbearing position.

Is multidetector computed tomography comparable to magnetic resonance imaging for assessment of lumbar foraminal stenosis?

2016 ◽  
Vol 58 (2) ◽  
pp. 197-203
Author(s):  
Woo Young Kang ◽  
Joong Mo Ahn ◽  
Joon Woo Lee ◽  
Eugene Lee ◽  
Yun Jung Bae ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Magnetic Resonance ◽  
Multidetector Computed Tomography ◽  
Excellent Agreement ◽  
Observer Agreement ◽  
Kappa Statistics ◽  
Foraminal Stenosis ◽  
Resonance Imaging ◽  
Lumbar Foraminal Stenosis

Background Both multidetector computed tomography (MDCT) and magnetic resonance imaging (MRI) are used for assessment of lumbar foraminal stenosis (LFS). Therefore, it is relevant to assess agreement between these imaging modalities. Purpose To determine intermodality, inter-, and intra-observer agreement for assessment of LFS on MDCT and MRI. Material and Methods A total of 120 foramina in 20 patients who visited our institution in January and February 2014 were evaluated by six radiologists with different levels of experience. Radiologists evaluated presence and severity of LFS on sagittal CT and MR images according to a previously published LFS grading system. Intermodality agreement was analyzed by using weighted kappa statistics, while inter- and intra-observer agreement were analyzed by using intraclass correlation coefficients (ICCs) and kappa statistics. Results Overall intermodality agreement was moderate to good (kappa, 0.478–0.765). In particular, two professors and one fellow tended to overestimate the degree of LFS on CT compared with MRI. For inter-observer agreement of all six observers, ICCs indicated excellent agreement for both CT (0.774) and MRI (0.771), while Fleiss’ kappa values showed moderate agreement for CT (0.482) and MRI (0.575). There was better agreement between professors and fellows compared with residents. For intra-observer agreement, ICCs indicated excellent agreement, while kappa values showed good to excellent agreement for both CT and MRI. Conclusion MDCT was comparable to MRI for diagnosis and assessment of LFS, especially for experienced observers. However, there was a tendency to overestimate the degree of LFS on MDCT compared with MRI.

scholarly journals Author Correction: Introduction and reproducibility of an updated practical grading system for lumbar foraminal stenosis based on high-resolution MR imaging

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Elisabeth Sartoretti ◽  
Michael Wyss ◽  
Alex Alfieri ◽  
Christoph A. Binkert ◽  
Cyril Erne ◽  
...  
Keyword(s):  
High Resolution ◽  
Mr Imaging ◽  
Grading System ◽  
Foraminal Stenosis ◽  
Lumbar Foraminal Stenosis

scholarly journals Transforaminal Epidural Balloon Adhesiolysis via a Contralateral Interlaminar Retrograde Foraminal Approach: A Retrospective Analysis and Technical Considerations

2020 ◽  
Vol 9 (4) ◽  
pp. 981
Author(s):  
Chan-Sik Kim ◽  
Yeon-Jin Moon ◽  
Jae Won Kim ◽  
Dong-Min Hyun ◽  
Shill Lee Son ◽  
...  
Keyword(s):  
Iliac Crest ◽  
Treatment Options ◽  
Balloon Catheter ◽  
Radicular Pain ◽  
Treatment Modalities ◽  
Foraminal Stenosis ◽  
The Novel ◽  
Lumbar Foraminal Stenosis ◽  
Transforaminal Approach ◽  
Technical Considerations

Several treatment modalities have been proposed for foraminal stenosis, but the treatment options remain unsatisfactory. Previous studies have shown that transforaminal balloon adhesiolysis may be effective in patients with refractory lumbar foraminal stenosis. However, in patients with a high iliac crest, balloon catheter insertion may be difficult via a conventional transforaminal approach (particularly targeting the L5–S1 foramen). It has been reported that an epidural catheter can be placed easily by a contralateral interlaminar retrograde foraminal approach. Therefore, we applied this approach to L5–S1 transforaminal balloon adhesiolysis in patients with a high iliac crest. We retrospectively analyzed data from 22 patients who underwent combined epidural adhesiolysis and balloon decompression (balloon adhesiolysis) using the novel foraminal balloon catheter via a contralateral interlaminar retrograde foraminal approach. The pain intensity significantly decreased over the three-month period after balloon adhesiolysis (p < 0.001). There were no complications associated with the balloon procedure. The present study suggests that balloon adhesiolysis for L5-S1 foramen via a contralateral interlaminar retrograde foraminal approach may be an effective alternative for patients with a high iliac crest and refractory lumbar radicular pain due to lumbar foraminal stenosis. In addition, detailed procedural aspects are described here.

357 Comparative Effectiveness between Primary and Revision Foraminotomy for the Treatment of Lumbar Foraminal Stenosis

Neurosurgery ◽  
2017 ◽  
Vol 64 (CN_suppl_1) ◽  
pp. 282-282
Author(s):  
Emily Hu ◽  
Jianning Shao ◽  
Heath P Gould ◽  
Roy Xiao ◽  
Colin Haines ◽  
...  
Keyword(s):  
Comparative Effectiveness ◽  
Retrospective Cohort ◽  
Minimum Clinically Important Difference ◽  
Functional Score ◽  
Foraminal Stenosis ◽  
Lumbar Foraminal Stenosis ◽  
Clinically Important Difference ◽  
Significant Difference ◽  
Functional Scores

Abstract INTRODUCTION Foraminotomy has demonstrated clinical benefit for the management of lumbar foraminal stenosis (LFS). Although many patients undergo multiple foraminotomies, there is little data comparing primary foraminotomy (PF) and revision foraminotomy (RF) in terms of cost and quality of life (QOL) outcomes. METHODS A retrospective cohort study was conducted among patients undergoing foraminotomy for LFS. QOL instruments (EQ-5D, PDQ, and PHQ-9) were prospectively collected between 2008 and 2016. Outcome measures included improvement in postoperative QOL, perioperative cost, and QOL minimum clinically important difference (MCID). RESULTS >579 procedures were eligible 476 (82%) PF and 103 (18%) RF. A significantly higher proportion of males underwent RF than PF (71% vs. 59%, P = 0.03) and PF was done on a significantly higher number of vertebral levels (2.2 vs. 2.0, P = 0.04). There were no other significant differences in demographics. Preoperatively, mean PDQ-Functional scores (50 vs. 54, P = 0.04), demonstrated significantly poorer QOL in the RF cohort. Postoperatively, EQ-5D index showed significant improvement in both the PF (0.547?0.648, P < 0.0001) and the RF (0.507?0.648, P < 0.0001) cohorts. Similarly, total PHQ-9 improved significantly in the PF cohort (7.84?5.91, P < 0.001) and in the RF cohort (8.55?5.53, P = 0.02), as did total PDQ (PF: 77?63, P < 0.0001; RF: 85?70, P = 0.04). QOL scores were also compared between groups preoperatively and postoperatively. The only significant difference between PF and RF was observed in preoperative PDQ-Functional score (50 vs. 54, P = 0.04). The proportion of patients achieving an MCID was not significantly associated with cohort. Finally, perioperative cost did not differ significantly between cohorts (PF: $13,383 vs. RF: $13,595, P = 0.82). CONCLUSION RF patients had poorer preoperative PDQ-Functional scores, but both PF and RF produce significant improvement in all measures. There was no difference in QOL outcomes or cost between PF and RF. Therefore, while one procedure does not clearly have superior cost effectiveness than the other, both achieved significant effectiveness.

Comparison of Pain-reducing Effect After Selective Nerve Root Block According to the Type of Lumbar Foraminal Stenosis

2019 ◽  
Vol 32 (2) ◽  
pp. E60-E64 ◽  
Author(s):  
Sangbong Ko ◽  
Jaibum Kwon ◽  
Youngsik Lee ◽  
Seungbum Chae ◽  
Wonkee Choi
Keyword(s):  
Nerve Root ◽  
Foraminal Stenosis ◽  
Lumbar Foraminal Stenosis ◽  
Nerve Root Block ◽  
Selective Nerve Root Block
Sign in / Sign up

Export Citation Format

Share Document