Factors of Adjacent Segment Disease Onset After Microsurgical Decompression for Lumbar Spinal Canal Stenosis

2020 ◽  
Vol 144 ◽  
pp. e110-e118
Author(s):  
Kunio Yokoyama ◽  
Makoto Yamada ◽  
Hidekazu Tanaka ◽  
Yutaka Ito ◽  
Akira Sugie ◽  
...  
Keyword(s):  
Spinal Canal ◽  
Disease Onset ◽  
Spinal Canal Stenosis ◽  
Adjacent Segment Disease ◽  
Adjacent Segment ◽  
Lumbar Spinal Canal Stenosis ◽  
Canal Stenosis ◽  
Microsurgical Decompression ◽  
Lumbar Spinal Canal ◽  
Lumbar Spinal

scholarly journals Stand-Alone Posterior Expandable Cage Technique for Adjacent Segment Degeneration with Lumbar Spinal Canal Stenosis: A Retrospective Case Series

Medicina ◽  
2021 ◽  
Vol 57 (3) ◽  
pp. 237
Author(s):  
Woo-Jin Choi ◽  
Seung-Kook Kim ◽  
Manhal Alaraj ◽  
Hyeun-Sung Kim ◽  
Su-Chan Lee
Keyword(s):  
Sagittal Balance ◽  
Spinal Canal ◽  
Interbody Fusion ◽  
Adjacent Segment Degeneration ◽  
Spinal Canal Stenosis ◽  
Adjacent Segment ◽  
Lumbar Spinal Canal Stenosis ◽  
Canal Stenosis ◽  
Lumbar Spinal ◽  
Expandable Cages

Background and Objectives: Symptomatic adjacent segment degeneration (ASD) with lumbar spinal canal stenosis (LSCS) is a common complication after spinal intervention, particularly interbody fusion. Stand-alone posterior expandable cages enable interbody fusion with preservation of the previous operation site, and screw-related complications are avoided. Thus, the aim of this study was to investigate the clinicoradiologic outcomes of stand-alone posterior expandable cages for ASD with LSCS. Materials and Methods: Patients with persistent neurologic symptoms and radiologically confirmed ASD with LSCS were evaluated between January 2011 and December 2016. The five-year follow-up data were used to evaluate the long-term outcomes. The radiologic parameters for sagittal balance, pain control (visual analogue scale), disability (Oswestry Disability Index), and early (peri-operative) and late (implant) complications were evaluated. Results: The data of 19 patients with stand-alone posterior expandable cages were evaluated. Local factors, such as intervertebral and foraminal heights, were significantly corrected (p < 0.01 and p < 0.01, respectively), and revision was not reported. The pain level (p < 0.01) and disability rate (p < 0.01) significantly improved, and the early complication rate was low (n = 2, 10.52%). However, lumbar lordosis (p = 0.62) and sagittal balance (p = 0.80) did not significantly improve. Furthermore, the rates of subsidence (n = 4, 21.05%) and retropulsion (n = 3, 15.79%) were high. Conclusions: A stand-alone expandable cage technique should only be considered for older adults and patients with previous extensive fusion. Although this technique is less invasive, improves the local radiologic factors, and yields favorable clinical outcomes with low revision rates, it does not improve the sagittal balance. For more widespread application, the strength of the cage material and high subsidence rates should be improved.

scholarly journals Wild-type transthyretin amyloid cardiomyopathy complicated by spinal canal stenosis, carpal tunnel syndrome, and rotator cuff tears: a case report

2020 ◽  
Author(s):  
Seiji Takashio ◽  
Masato Nishi ◽  
Yuichiro Tsuruta ◽  
Kenichi Tsujita
Keyword(s):  
Rotator Cuff ◽  
Spinal Canal ◽  
Spinal Canal Stenosis ◽  
Rotator Cuff Tears ◽  
Lumbar Spinal Canal Stenosis ◽  
Canal Stenosis ◽  
Tunnel Syndrome ◽  
Amyloid Cardiomyopathy ◽  
Lumbar Spinal Canal ◽  
Lumbar Spinal

Abstract Background Wild-type transthyretin amyloid cardiomyopathy (ATTRwt-CM) is receiving increasing attention due to the availability of novel treatment options. Carpal tunnel syndrome (CTS) and lumbar spinal canal stenosis are known early symptoms of transthyretin (TTR) amyloidosis preceding the cardiac involvement and are considered as ‘Red Flags’ for transthyretin amyloid cardiomyopathy (ATTR-CM). Case summary A 67-year-old man with a history of lumbar spinal canal stenosis for the last 10 years, right rotator cuff tears for the last 4 years, and bilateral CTS for the last 1 year was scheduled for orthopaedic surgery for lumbar spinal canal stenosis. Investigations revealed severe left ventricular hypertrophy and hypertroponinaemia, which were suggestive of cardiac amyloidosis. Cardiac magnetic resonance imaging and 99mTc-labelled pyrophosphate scintigraphy demonstrated positive findings for ATTR-CM. Transthyretin deposition was found in both the myocardium and the yellow ligamentum excised during surgery. There was no transthyretin mutation on genetic testing. The final diagnosis was ATTRwt-CM. Discussion Transthyretin deposition in the ligaments or tendons has been observed in a number of patients with CTS, spinal canal stenosis, and rotator cuff tears. These orthopaedic diseases are predictive for the future occurrence of ATTR-CM. In addition, the coexistence of these multiple diseases might strongly predict ATTR-CM. This knowledge needs to be shared with orthopaedicians and cardiologists for the early diagnosis of ATTR-CM.

scholarly journals Surgical treatments for lumbar spinal canal stenosis.

1987 ◽  
Vol 35 (3) ◽  
pp. 888-891
Author(s):  
Hirofumi Harada ◽  
Kenji Utsunomiya ◽  
Shougo Masumi ◽  
Nobutaka Kuroya
Keyword(s):  
Spinal Canal ◽  
Spinal Canal Stenosis ◽  
Lumbar Spinal Canal Stenosis ◽  
Canal Stenosis ◽  
Lumbar Spinal Canal ◽  
Lumbar Spinal ◽  
Surgical Treatments

scholarly journals Posterior Decompression Usign METRx-MD System for Lumbar Spinal Canal Stenosis

2006 ◽  
Vol 55 (4) ◽  
pp. 467-470
Author(s):  
Masaki Yoh ◽  
Masayoshi Oga ◽  
Junichi Arima ◽  
Ko Ikuta ◽  
Soichiro Nakano ◽  
...  
Keyword(s):  
Spinal Canal ◽  
Spinal Canal Stenosis ◽  
Lumbar Spinal Canal Stenosis ◽  
Posterior Decompression ◽  
Canal Stenosis ◽  
Lumbar Spinal Canal ◽  
Lumbar Spinal

scholarly journals Clinical and Roentgenographic Studies for the Lumbar Spinal Canal Stenosis

1974 ◽  
Vol 23 (3) ◽  
pp. 272-275
Author(s):  
M. Naruo ◽  
H. Takahashi ◽  
T. Higashihara ◽  
T. Sakae ◽  
K. Morimoto ◽  
...  
Keyword(s):  
Spinal Canal ◽  
Spinal Canal Stenosis ◽  
Lumbar Spinal Canal Stenosis ◽  
Canal Stenosis ◽  
Lumbar Spinal Canal ◽  
Lumbar Spinal

scholarly journals Clinical and radiological studies of lumbar spinal canal stenosis.

1984 ◽  
Vol 32 (1) ◽  
pp. 163-167
Author(s):  
S. Yano ◽  
T. Yano ◽  
H. Hieda ◽  
N. Nagata ◽  
Y. Ishibashi ◽  
...  
Keyword(s):  
Spinal Canal ◽  
Spinal Canal Stenosis ◽  
Lumbar Spinal Canal Stenosis ◽  
Canal Stenosis ◽  
Lumbar Spinal Canal ◽  
Lumbar Spinal ◽  
Radiological Studies

scholarly journals Outcome of decompressive operative procedure in the treatment of degenerative lumbar spinal canal stenosis: experience of managing consecutive 25 cases

2020 ◽  
Vol 10 (2) ◽  
pp. 103-107
Author(s):  
Apel Chandra Saha ◽  
Md Hasan Masud ◽  
Md Abdul Haque ◽  
Mohammad Zulfiqur Haider Sarker
Keyword(s):  
Spinal Canal ◽  
Spinal Canal Stenosis ◽  
City Hospital ◽  
Lumbar Spinal Canal Stenosis ◽  
Interventional Study ◽  
Average Hospital ◽  
Canal Stenosis ◽  
Lumbar Spinal Canal ◽  
Lumbar Spinal

Background: Lumbar spinal canal stenosis (LSCS) is a common medical disorder due to degenerative changesin the middle age and older individual. In this condition, narrowing of lumbar spinal canal and nerve rootcanal leads to painful, debilitating compression of spinal nerves and blood vessels. Decompressive surgery inlumbar spinal canal stenosis is one of modern methods of treatment.The objective of this study was to evaluate the outcome of decompressive operative management in degenerativelumbar spinal canal stenosis. Methods: Thiswas a prospective interventional study carried out at National Institute of Traumatology andOrthopaedic Rehabilitation (NITOR) and City Hospital, Lalmatia, Dhaka from October 2012 to December2014.Total number of patients were 25 who underwent decompressive surgical procedures. Each of patientswas evaluated by the visual analogue scale (VAS) for pain, disability by using Oswestry disability index (ODI)and ModifiedMacnab Criteria (MMC)for assessment of improvement. Results: This was a prospective interventional study carried out at National Institute Of Traumatology and OrthopaedicRehabilitation (NITOR) and City hospital, Lalmatia, Dhaka from October 2012 to December 2014. Out of 25patients, 19 patients(76%)were male and 6 patients (24%) were female, age ranged from 38-65 years with the meanage 48.50 ± 8.65 years. Sixteen (64%) patients were manual worker and 9 patients (36%) were sedentary worker.Sixteen (64%) patients had multilevel stenosis and 9 patients (36%) had single level stenosis. The mean follow upduration was 1.5 years (range: 1-3 years). Mean estimated blood loss was 150ml (range : 100-200ml), meansurgery time was 130mutes (range: 80-180min) and average hospital stay was 7 days (range: 4-10 days). Only 1patient (4%) had discitis, 1 patient (4%) had superficial wound infection and 1 patient (4%) had dural tear. AsMMC, 21 (84%) patients was poor before operation and after operation at 12 months follow up 8 patients (32%)had excellent, 12 patients (48%) had good, 4 patients (16%) had fair and 1 patient (4%) had poor functionaloutcome. Mean (SD) ODI were 75.40 (± 5.01) before operation and reduced to 8.36 (± 13.54) after operation at 3rd(12 month) follow up. Mean (SD) VAS was 7.12 (± 0.86) before operation and reduced to 1.46 (± 1.31) afteroperation at 3rd (12 month) follow up. Twenty (80%) patients had satisfactory functional outcome. Conclusion: Decompressive operation is an effective, safe and acceptable method of treatment in degenerativelumbar spinal canal stenosis (LSCS). Birdem Med J 2020; 10(2): 103-107

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