Minimally Invasive Lumbar Spinal Decompression in the Elderly: Outcomes of 50 Patients Aged 75 Years and Older

2008 ◽  
Vol 2008 ◽  
pp. 287-289
Author(s):  
C.O. Ohaegbulam
Keyword(s):  
Minimally Invasive ◽  
The Elderly ◽  
Spinal Decompression ◽  
Lumbar Spinal ◽  
Lumbar Spinal Decompression

Evaluation and management of small dural tears in primary lumbar spinal decompression and discectomy surgery

2018 ◽  
Vol 50 ◽  
pp. 177-182 ◽  
Author(s):  
Marcelo Galarza ◽  
Roberto Gazzeri ◽  
Raúl Alfaro ◽  
Pedro de la Rosa ◽  
Cinta Arraez ◽  
...  
Keyword(s):  
Spinal Decompression ◽  
Dural Tears ◽  
Lumbar Spinal ◽  
Lumbar Spinal Decompression

Reliability of postoperative MR imaging in the determination of level and side of lumbar spinal decompression surgery

2016 ◽  
Vol 58 (5) ◽  
pp. 581-585
Author(s):  
Florian Wanivenhaus ◽  
Florian M Buck ◽  
Michael Betz ◽  
Nadja A Farshad-Amacker ◽  
Mazda Farshad
Keyword(s):  
High Reliability ◽  
Surgical Decompression ◽  
Time Interval ◽  
Decompression Surgery ◽  
Mr Images ◽  
Spinal Decompression ◽  
Lumbar Spinal ◽  
Lumbar Spinal Decompression ◽  
Musculoskeletal Radiologist

Background Magnetic resonance imaging (MRI) is the diagnostic modality of choice in defining soft tissue compromise of the spinal canal. Purpose To evaluate the reliability of postoperative MRI in the determination of level and side of lumbar spinal decompression surgery, investigated by two reviewers, in different levels of training and specialization. Material and Methods Postoperative MR images of 86 patients who underwent spinal decompression (single level, n = 70; multilevel, n = 16; revision decompression, n = 9) were reviewed independently by an experienced musculoskeletal radiologist and a fourth-year orthopedic surgery resident. The level (single or multiple) and side of previous surgical decompression were determined and compared to the surgical notes. We examined factors that may have influenced the reliability, including demographics, type of surgical decompression, use of a drain, and time interval from surgery to MRI. Results Significantly fewer levels were correctly determined by the resident (77/86 cases, 89.5%) compared with the radiologist (84/86 cases, 97.7%) ( P = 0.014). The resident interpreted significantly more MR images incorrectly in cases where a drain was used (n = 8; P < 0.001). Re-decompression cases were interpreted incorrectly significantly more often by both the radiologist (n = 2, P = 0.032) and the resident (n = 4, P = 0.014). Conclusion Determination of the level and side operated on in previous lumbar spinal decompression surgery on MRI has a high reliability, especially when performed by a musculoskeletal radiologist. However, this reliability is decreased in cases involving surgical drainage and same-level revision surgery.

scholarly journals Anatomical Landmarks for Microscopic Bilateral Lumbar Spinal Decompression via Unilateral Laminotomy

2011 ◽  
Vol 25 (2) ◽  
pp. 203-208 ◽  
Author(s):  
Manabu Sasaki ◽  
Masanori Aoki ◽  
Masaaki Fujiwara ◽  
Toshiki Yoshimine
Keyword(s):  
Anatomical Landmarks ◽  
Spinal Decompression ◽  
Lumbar Spinal ◽  
Lumbar Spinal Decompression

scholarly journals Unexpectedly High Block following Epidural Catheter Placement under Direct Vision: A Case Report

2005 ◽  
Vol 33 (1) ◽  
pp. 128-130 ◽  
Author(s):  
A. D'Agapeyeff ◽  
I. J. Crabb
Keyword(s):  
Mechanical Ventilation ◽  
Case Report ◽  
Epidural Catheter ◽  
Literature Search ◽  
Case Reports ◽  
Direct Vision ◽  
Spinal Decompression ◽  
Epidural Catheter Placement ◽  
Lumbar Spinal ◽  
Lumbar Spinal Decompression

A 72-year-old female underwent elective lumbar spinal decompression. At the end of the procedure an epidural catheter was sited by the surgeon under direct vision. A bolus of levobupivacaine was injected. Shortly after reaching the recovery area, the patient collapsed and required re-intubation and mechanical ventilation. She was extubated five hours later and suffered no adverse sequelae. Having excluded other possible causes of immediate post-operative collapse, a clinical diagnosis of subdural blockade was made. A literature search using Medline has found no other case reports of such a complication following epidural placement under direct vision.

MINIMALLY INVASIVE LUMBAR SPINAL DECOMPRESSION IN THE ELDERLY

Neurosurgery ◽  
2007 ◽  
Vol 60 (3) ◽  
pp. 503-510 ◽  
Author(s):  
David S. Rosen ◽  
John E. O'Toole ◽  
Kurt M. Eichholz ◽  
Melody Hrubes ◽  
Dezheng Huo ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Elderly Patients ◽  
Oswestry Disability Index ◽  
Short Form ◽  
The Elderly ◽  
Surgical Decompression ◽  
Analog Scale ◽  
Pain Scores ◽  
Lumbar Spinal

Abstract OBJECTIVE Lumbar spinal stenosis and spondylosis are major causes of morbidity among the elderly. Surgical decompression is an effective treatment, but many elderly patients are not considered as candidates for surgery based on age or comorbidities. Minimally invasive surgical techniques have recently been developed and used successfully for the treatment of lumbar spinal disease. Our objective was to examine the safety and efficacy of minimally invasive lumbar spinal surgery for elderly patients. METHODS We reviewed demographic information, pre- and postoperative Visual Analog Scale pain scores, Oswestry Disability Index scores, and Short-Form 36 scores of prospectively accrued patients who underwent minimally invasive decompression of lumbar degenerative disease at two institutions between January 2002 and December 2005. Data from patients who were at least 75 years old were selected. Statistical analysis methods included paired t test, multiple linear regression, and linear mixed effects modeling. RESULTS Fifty-seven patients with a mean age of 81 years met the study criteria (median follow-up period, 7 mo; mean follow-up period, 10 mo). No major complications or deaths occurred. Fifty patients had sufficient outcomes data for analysis. Visual Analog Scale pain scores decreased from 5.7 to 2.2 for back pain and from 5.7 to 2.3 for symptomatic leg pain (P &lt; 0.05). Oswestry Disability Index scores decreased from 48 to 27; Short-Form 36 Body Pain and Physical Function scores also showed statistically significant improvements after surgery (P &lt; 0.05). The longitudinal analysis demonstrated durability of the symptom relief. CONCLUSION Minimally invasive lumbar spine decompression is a safe and efficacious treatment for elderly patients with spinal stenosis and spondylosis. Elderly patients should be considered good candidates for lumbar surgical decompression using minimally invasive techniques.

Lumbar Spinal Stenosis and Neurogenic Claudication

2017 ◽  
Author(s):  
Laxmaiah Manchikanti ◽  
Sheri L Albers ◽  
Richard Latchaw
Keyword(s):  
Spinal Cord ◽  
Minimally Invasive ◽  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Spinal Cord Stimulation ◽  
Neurogenic Claudication ◽  
Spinal Decompression ◽  
Epidural Injections ◽  
Interspinous Spacers ◽  
Lumbar Spinal

Lumbar spinal stenosis is a degenerative condition that develops and progresses slowly over time. Lumbar spinal stenosis may be local, segmental, or generalized. The majority of lumbar spinal stenosis cases are acquired, degenerative stenosis, resulting from aging of the spine or following surgery or infection. Management of lumbar spinal stenosis is challenging and requires the integration of the history, clinical findings, and results of diagnostic imaging. Magnetic resonance imaging is the most commonly used imaging modality in diagnosing lumbar spinal stenosis. Typical features of spinal stenosis with neurogenic claudication include an increase in symptoms with extension and a decrease with flexion. With lateral recess stenosis or foraminal stenosis, isolated radiculopathy can occur. Spinal stenosis is classified as mild, moderate, and severe, ranging from one third to two thirds of the canal, and grade I to grade III classification of neurogenic intermittent claudication. Management of lumbar spinal stenosis is largely conservative except in cases of severe spinal stenosis and neurogenic claudication with or without paresis and other symptoms. Nonsurgical management of lumbar spinal stenosis includes drugs, physiotherapy, epidural injections, multidisciplinary rehabilitation, and spinal cord stimulation. Minimally invasive techniques include minimally invasive lumbar spinal decompression, interspinous spacers, and endoscopic surgical decompression. The final treatments include open surgery with decompression with or without fusion and spinal cord stimulation. Key words: acquired stenosis, central spinal stenosis, congenital stenosis, decompression with fusion, decompression without fusion, endoscopic spinal decompression, epidural injections, foraminal spinal stenosis, interspinous spacers, lateral spinal stenosis, lumbar spinal stenosis, minimally invasive lumbar decompression, neurogenic claudication, percutaneous adhesiolysis, shopping cart syndrome, spondylolisthesis, vascular claudication

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