Lumbar spinous process-splitting technique for ligamentum flavum cyst removal: the first use in Europe.

2021 ◽  
Author(s):  
Santino Ottavio Tomasi ◽  
Giuseppe Emmanuele Emmanuele Umana ◽  
Gianluca Scalia ◽  
Giuseppe Raudino ◽  
Vlado Stevanovic ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Ligamentum Flavum ◽  
Spinous Process ◽  
Case Series ◽  
Invasive Technique ◽  
Paraspinal Muscles ◽  
Splitting Technique ◽  
Lumbar Canal Stenosis ◽  
Canal Stenosis ◽  
Lumbar Spinous Process

Background Laminotomy for lumbar stenosis is a well-defined procedure and represents a routine in every neurosurgical department. It is a common experience that the mono- or bilateral paraspinal muscles detachment together with supra and interspinous ligaments injury can lead to postoperative pain. In literature has been reported the application at the level of the lumbar spine of a minimally invasive technique defined as lumbar spinous process-splitting technique (LSPST). Methods In the current study, we present a case series of 12 patients that underwent LSPSL from September 2019 to April 2020. Two patient suffering from ligamentum flavum cyst, 8 patients with single level lumbar canal stenosis (LCS) and two patients with two-level LCS. The approach was mini-open, with reduced soft tissue dissection and without paraspinal muscles injury. Moreover, a novel morphological classification of postoperative muscle atrophy is proposed as well as a volumetric analysis of the decompression achieved. Conclusion At our knowledge, this is the first description of this surgical technique and the first LSPSL case series in Europe. Furthermore, cases of ligamentum flavum cyst removal using this safe and effective technique are not yet reported. Abbreviations Lumbar canal stenosis (LCS), lumbar spinous process-splitting technique (LSPST), minimally invasive spine surgery (MISS)

Lumbar spinous process—splitting laminectomy for lumbar canal stenosis

2005 ◽  
Vol 3 (5) ◽  
pp. 405-408 ◽  
Author(s):  
Kota Watanabe ◽  
Toshihiko Hosoya ◽  
Tateru Shiraishi ◽  
Morio Matsumoto ◽  
Kazuhiro Chiba ◽  
...  
Keyword(s):  
Spinous Process ◽  
Paraspinal Muscles ◽  
Paravertebral Muscle ◽  
Content Type ◽  
Lumbar Canal Stenosis ◽  
Canal Stenosis ◽  
The Mean ◽  
Supporting Structures ◽  
Lumbar Spinous Process ◽  
Fine Print

✓ In conventional laminectomy for lumbar canal stenosis (LCS), intraoperative damage of posterior supporting structures can lead to irreversible atrophy of paraspinal muscles. In 2001, the authors developed a new procedure for lumbar laminectomy, the lumbar spinous process—splitting laminectomy (LSPSL). In this new procedure, the spinous process is split longitudinally in the middle and then divided at its base from the posterior arch, leaving the bilateral paraspinal muscles attached to the lateral aspects. Ample working space for laminectomy is obtained by retracting the split spinous process laterally together with its attached paraspinal muscles. After successfully decompressing nerve tissues, each half of the split spinous process is reapproximated using a strong suture. Thus, the supra- and interspinous ligaments are preserved, as is the spinous process, and damage to the paraspinal muscles is minimal. Eighteen patients with LCS underwent surgery in which this new technique was used. Twenty patients in whom conventional laminectomy was undertaken were chosen as controls. At 2 years, the clinical outcomes (as determined using the Japanese Orthopaedic Association [JOA] scores and recovery rate) and the rate of measured magnetic resonance imaging—documented paravertebral muscle atrophy were evaluated and compared between the two groups. The mean JOA score recovery rates were 67.6 and 59.2%, respectively, for patients treated with LSPSL and conventional laminectomy; the mean rates of paravertebral muscle atrophy were 5.3 and 23.9%, respectively (p = 0.0005). Preservation of posterior supporting structures and satisfactory recovery rate after 2 years indicated that this technique can be a useful alternative to conventional decompression surgery for lumbar canal stenosis.

scholarly journals PRELIMINARY RESULTS OF VERTEBRAL CANAL DECOMPRESSION BY SPINOUS PROCESS SPLITTING

2019 ◽  
Vol 18 (3) ◽  
pp. 231-235
Author(s):  
THIAGO DANTAS MATOS ◽  
YONY OSORIO GARCIA ◽  
HERTON RODRIGO TAVARES COSTA ◽  
HELTON LUIZ APARECIDO DEFINO
Keyword(s):  
Surgical Treatment ◽  
Spinous Process ◽  
Lower Limbs ◽  
Radiographic Evaluation ◽  
Splitting Technique ◽  
Lumbar Canal Stenosis ◽  
Preliminary Results ◽  
Canal Stenosis ◽  
Lower Limb Pain ◽  
The Mean

ABSTRACT Objective Considering that the technique of spinous process splitting has been advocated as a less invasive treatment of lumbar stenosis, the objective of this study was to evaluate the preliminary results of this technique in the surgical treatment of lumbar canal stenosis. Methods Twenty patients with lumbar spinal canal stenosis who underwent surgical treatment for lumbar canal decompression with the spinous process splitting technique were assessed in the preoperative period and on postoperative days 1, 7 and 30 for VAS for lower back and lower limbs pain and radiographic evaluation of the operated segment. Results The mean visual analogue scale score for lumbar pain in the preoperative assessment was 4.2 ± 3.37 and 0.85 ± 0.88, 1.05 ± 1.19 and 1.15 ± 1.04 after 1, 7 and 30 postoperative days, respectively. The mean VAS score for lower limb pain was 8 ± 1.72 preoperatively, and 0.7 ± 1.13, 0.85 ± 1.04, and 1.05 ± 1 after 1, 7, and 30 postoperative days, respectively. There were no radiographic signs of instability of the vertebral segment operated in the radiographic evaluation. Conclusions Decompression of the lumbar canal through the spinous process splitting technique in patients with lumbar canal stenosis had good immediate and short-term results in relation to low back and lower limbs pain. Level of evidence IV; Therapeutic Study.

scholarly journals Complications Associated with Microscopic Lumbar Spinous Process-splitting Laminectomy for Degenerative Lumbar Canal Stenosis

2015 ◽  
Vol 29 (3) ◽  
pp. 304-309
Author(s):  
Makoto Senoo ◽  
Tsukasa Sato ◽  
Daisuke Mori ◽  
Mikio Nishiya ◽  
Yasufumi Otake
Keyword(s):  
Spinous Process ◽  
Lumbar Canal Stenosis ◽  
Canal Stenosis ◽  
Lumbar Spinous Process

Comparison of Short-Term Clinical Results and Radiologic Changes Between Two Different Minimally Invasive Decompressive Surgical Methods for Lumbar Canal Stenosis

Spine ◽  
2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Sunao Tanaka ◽  
Kanichiro Wada ◽  
Gentaro Kumagai ◽  
Toru Asari ◽  
Shuichi Aburakawa ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Clinical Results ◽  
Short Term ◽  
Lumbar Canal Stenosis ◽  
Canal Stenosis ◽  
Surgical Methods

scholarly journals Achilles tendon repair by a minimally invasive technique using Tenolig®

2020 ◽  
Vol 14 (3) ◽  
pp. 269-273
Author(s):  
Vinicius Oliveira ◽  
Sérgio Prata
Keyword(s):  
Minimally Invasive ◽  
Achilles Tendon ◽  
Postoperative Infection ◽  
Tendon Rupture ◽  
Achilles Tendon Rupture ◽  
Case Series ◽  
Minimally Invasive Technique ◽  
Invasive Technique ◽  
Aofas Score ◽  
Functional Scores

Objective: To assess the degree of postoperative satisfaction of patients with acute Achilles tendon rupture who underwent surgical reconstruction by a minimally invasive technique using Tenolig®. Methods: A retrospective observational study was conducted with 18 patients with acute Achilles tendon rupture diagnosed by a positive Thompson test who underwent surgery. Outcomes were assessed using the American  arthopaedic Foot and Ankle Society (AOFAS) score and the Foot Function Index (FFI). Furthermore, quantitative variables were descriptively treated, and patients’ age was correlated with FII and AOFAS score using Spearman’s correlation coefficient at a significance level of 5%. Results: Patients underwent surgery from one to six days after injury and were discharged one day later. Only one patient had a superficial postoperative infection. Patients’ AOFAS scores ranged from 75 to 100 points, and FFI ranged from 0 to 20%. The patient withsuperficial postoperative infection had an AOFAS score and a FFI of 75 points and 20%, respectively. Conclusion: Percutaneous repair of complete Achilles tendon rupture with Tenolig® resulted in high functional scores and a low rate of complications. Level of Evidence IV; Therapeutic Studies; Case Series.

scholarly journals Ligamentum Flavum Cyst - A Rare Cause of Lumbar Canal Stenosis: A Case Report with Review of Literature

2021 ◽  
Vol 6 (1) ◽  
pp. 57-60
Author(s):  
Sanyam Jain ◽  
Pankaj Jindal ◽  
Puneet Girdhar ◽  
Bhupendra Bharti ◽  
Rajesh Verma
Keyword(s):  
Case Report ◽  
Ligamentum Flavum ◽  
Review Of Literature ◽  
Lumbar Canal Stenosis ◽  
Canal Stenosis

scholarly journals P.138 Minimally invasive treatment of syringomyelia using tubular retractors

2018 ◽  
Vol 45 (s2) ◽  
pp. S53-S53
Author(s):  
K Yang ◽  
M Sourour ◽  
N Zagzoog ◽  
K Reddy
Keyword(s):  
Minimally Invasive ◽  
Chart Review ◽  
Case Series ◽  
Retrospective Chart Review ◽  
Senior Author ◽  
Invasive Technique ◽  
Single Center ◽  
Invasive Treatment ◽  
Multiple Modalities ◽  
Subarachnoid Spaces

Background: Multiple modalities have been used in the treatment of syringomyelia, including direct drainage, shunting into peritoneal, pleural and subarachnoid spaces. The authors report their experience of surgical treatment of syringomyelia in a minimally invasive fashion. Methods: We conducted a single-center retrospective chart review on our syringomyelia cases treated with minimally invasively using Metrx Quadrant retractor system since January 2011. Lateral fluoroscopy was used to guide the placement of the retractor onto the lamina of the corresponding level. This was followed by laminectomy and a small durotomy. Once the syrinx cavity was identified and the proximal end of the tubing was inserted into the syrinx cavity, the tubing was tunneled into the pleural incision subcutaneously. Insertion of the pleural end of the shunt was performed under the microscope, with removal of a small amount of the rib at its upper edge. Results: 10 procedures were performed in 7 patients by the senior author. Etiologies of syringomyelia included Chiari malformation, trauma, diastematomyelia and kyphoscoliosis. All patients improved neurologically. No patients had immediate postoperative complications. One patient underwent two revisions of syringopleural shunts due to multilobulated nature of syringomyelia. Conclusions: Our case series presents a novel, minimally invasive technique for shunting of syringomyelia with results comparable to open procedures.

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