238. Postoperative development of instability or deformity following decompressive laminectomy surgery for lumbar spinal stenosis

2021 ◽  
Vol 21 (9) ◽  
pp. S122-S123
Author(s):  
Christopher G. Furey ◽  
Innocent Njoku ◽  
Zachary L. Gordon ◽  
Nicholas U. Ahn
Keyword(s):  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Decompressive Laminectomy ◽  
Lumbar Spinal

scholarly journals The relationship between preoperative predictive factors for clinical outcome in patients operated for lumbar spinal stenosis by decompressive laminectomy

2020 ◽  
Vol 11 ◽  
pp. 27 ◽  
Author(s):  
Dobran Mauro ◽  
Davide Nasi ◽  
Riccardo Paracino ◽  
Mara Capece ◽  
Erika Carrassi ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Predictive Factors ◽  
Antidepressant Drugs ◽  
Decompressive Laminectomy ◽  
Pain Anxiety ◽  
Pain Medications ◽  
Improved Outcomes ◽  
Lumbar Spinal

Background: Our hypothesis was that by identifying certain preoperative predictive factors, we could favorably impact clinical outcomes in patients undergoing decompressive surgery for lumbar spinal stenosis (LSS). Methods: In this retrospective study, there were 65 patients (2016–2018) with symptomatic LSS who underwent decompressive laminectomy without fusion. Their clinical outcomes were assessed utilizing the Oswestry Disability Index (ODI). Multiple preoperative variables were studied to determine which ones would help predict improved outcomes: gender, age, body mass index (BMI), general/neurological examination, smoking, and drug therapies (anxiolytics and/or antidepressants). Results: All patients demonstrated statistically significant improvement on the ODI. Multivariate analysis revealed that those with higher preoperative BMI had significantly lower ODI on 1-year follow-up examinations, reflecting poorer outcomes. Postoperatively, 44 patients (67%) exhibited lower utilization of anxiolytic medications, 52 patients (80%) showed reduced use of antidepressant drugs, and pain medications utilization was reduced in 33 patients (50%). Conclusion: Decompressive laminectomy without fusion effectively managed LSS. It reduced patients’ use of pain, anxiety, and antidepressant medications. In addition, we found that increased preoperative BMIs contributed to poorer postoperative outcomes (e.g., ODI values).

scholarly journals Indications for fusion following decompression for lumbar spinal stenosis

1997 ◽  
Vol 3 (2) ◽  
pp. E4 ◽  
Author(s):  
Mark W. Fox ◽  
Burton M. Onofrio
Keyword(s):  
Clinical Outcomes ◽  
Elderly People ◽  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Decompressive Surgery ◽  
Common Condition ◽  
Decompressive Laminectomy ◽  
Degenerative Lumbar Spinal Stenosis ◽  
Lumbar Spinal ◽  
Better Than

Degenerative lumbar spinal stenosis is a common condition affecting middle-aged and elderly people. Significant controversy exists concerning the appropriate indications for fusion following decompressive surgery. The purpose of this report is to compare the clinical outcomes of patients who were and were not treated with fusion following decompressive laminectomy for spinal stenosis and to identify whether fusion was beneficial. The authors conclude that patients in whom concomitant fusion procedures were performed fared better than patients who were treated by means of decompression alone when evidence of radiological instability existed preoperatively.

scholarly journals Microscopic decompressive laminectomy versus percutaneous endoscopic decompressive laminectomy in patients with lumbar spinal stenosis: protocol for a systematic review and meta-analysis

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e037096
Author(s):  
Rong Wang ◽  
Xiuxia Li ◽  
Xiaogang Zhang ◽  
Daping Qin ◽  
Guodong Yang ◽  
...  
Keyword(s):  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Meta Analysis ◽  
The Elderly ◽  
Cochrane Library ◽  
Lumbar Degenerative Disease ◽  
Decompressive Laminectomy ◽  
Ethical Approval ◽  
Randomised Controlled ◽  
Lumbar Spinal

IntroductionLumbar spinal stenosis (LSS) is a common lumbar degenerative disease in the elderly, usually requiring surgery if conservative treatment fails. Microscopic decompressive laminectomy (MDL) and percutaneous endoscopic decompressive laminectomy (PEDL) have been widely used to treat LSS. This study aims to provide a protocol for the evaluation and comparison of the efficacy, safety and applicability between MDL and PEDL.Methods and analysisWe will search for randomised controlled trials (RCTs) comparing MDL and PEDL for treating LSS from inception to December 2019 in the following databases: PubMed, The Cochrane Library, Web of Science, Embase and China Biology Medicine. The quality of included studies will be assessed using the risk of bias tool recommended by the Cochrane Handbook 5.2.0. Subsequently, a meta-analysis will be performed using RevMan 5.3 software.Ethics and disseminationGiven the nature of this study, no ethical approval will be required. The protocol will be disseminated via a peer-reviewed journal.PROSPERO registration numberCRD42020164765.

Assessment of bladder function after lumbar decompressive laminectomy for spinal stenosis: a prospective study

1994 ◽  
Vol 80 (6) ◽  
pp. 971-974 ◽  
Author(s):  
H. Gordon Deen ◽  
Richard S. Zimmerman ◽  
Scott K. Swanson ◽  
Thayne R. Larson
Keyword(s):  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Bladder Dysfunction ◽  
Urine Volume ◽  
Bladder Function ◽  
Leg Pain ◽  
Residual Urine Volume ◽  
Decompressive Laminectomy ◽  
Spinal Segments ◽  
Lumbar Spinal

✓ Lumbar spinal stenosis is a common problem in elderly patients. In its more advanced forms, it typically causes intractable leg pain, but many patients also manifest varying degrees of bladder dysfunction. The goal of lumbar decompressive laminectomy is relief of leg pain and paresthesias, yet some patients also achieve improvement in bladder function. This study prospectively investigated patients with lumbar spinal stenosis to determine whether laminectomy had any effect on urological function. Of the 20 patients in the study, 10 were men and 10 women (average age 70.9 years). All patients had severe lumbar stenosis affecting between two and four spinal segments, and all reported some degree of bladder dysfunction. Cystoscopy and urodynamic testing were completed preoperatively. A standard decompressive laminectomy was performed over the appropriate number of spinal segments. Urodynamic studies were repeated at 2 and 6 months postoperatively. At the 6-month follow-up review, bladder function was subjectively improved in 12 patients (60%) and unchanged in eight (40%). Postvoiding residual urine volume was the urodynamic factor most likely to be improved by laminectomy. In nine patients (45%), baseline postvoiding residual urine volume was elevated and all nine had improvement postoperatively. In the remaining 11 patients (55%), this urine volume was normal before and after surgery. Maximum urine flow rates also improved, but the results of cytometrography and electromyography, urine flow pattern, and bladder capacity were unchanged postoperatively. Cystoscopy detected previously undiagnosed malignancy of the lower urinary tract in two patients (10%). It is concluded that lumbar decompressive laminectomy can have a beneficial effect on bladder function in a significant number of patients with advanced lumbar spinal stenosis.

scholarly journals Dynamic Changes of Cauda Equina Motion Before and After Decompressive Laminectomy for Lumbar Spinal Stenosis With Redundant Nerve Roots: Cauda Equina Activation Sign

2019 ◽  
Vol 9 (6) ◽  
pp. 619-623 ◽  
Author(s):  
Yosuke Kawasaki ◽  
Atsushi Seichi ◽  
Liuzhe Zhang ◽  
Shoichiro Tani ◽  
Atsushi Kimura
Keyword(s):  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Cauda Equina ◽  
Nerve Roots ◽  
Decompressive Laminectomy ◽  
Before And After ◽  
Lumbar Spinal ◽  
Type 3

Study Design: Cross-sectional observational study (consecutive case series). Objectives: The aim of this study was to define a criterion for achieving successful decompression of lumbar spinal stenosis (LSS) using intraoperative ultrasonography (IOUS) and to investigate the pathogenesis of redundant nerve roots (RNRs) based on the ultrasonographic findings. Methods: A total of 100 LSS patients (71 males, 29 females, mean age, 71 ± 8 years) with RNRs were enrolled as subjects in this study. IOUS was performed to evaluate pulsatile motion of the cauda equina (PMCE) just before and after decompressive laminectomy. To determine the decompression status of the cauda equina, the ultrasonographic findings were classified into 3 types on the basis of the presence or absence of PMCE: type 1, predecompression PMCE (−) to postdecompression PMCE (+); type 2, pre- and postdecompression PMCE (+); and type 3, pre- and postdecompression PMCE (−). The pathogenesis of RNRs was also investigated based on the ultrasonographic findings. Results: Around the stenosis, PMCE was almost always absent before decompression and appeared after decompression (type 1 in 94 patients, type 2 in 6, type 3 in 0). IOUS showed that, before decompression, the cauda equina was held at the stenosis and could not pulsate beyond the stenotic site, and after decompression, PMCE recovered in the craniocaudal direction, leading to the resolution of RNRs. Conclusions: The emergence of PMCE can be a sign of successful decompression for LSS. Ultrasonographic findings support the notion that disturbance of PMCE around the stenosis is a basic component of the pathogenesis of RNRs.

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