Lumbar spinal disease

2019 ◽  
pp. 719-732
Author(s):  
Christopher G Kellett ◽  
Matthew J Crocker
Keyword(s):  
Clinical Features ◽  
Ageing Population ◽  
Spinal Disease ◽  
Comprehensive Understanding ◽  
Load Bearing ◽  
Motion Segment ◽  
Spinopelvic Balance ◽  
Lumbar Spinal ◽  
Spinal Function

Spinal pathology comprises greater than 50% of the neurosurgeon’s workload. Therefore, a comprehensive understanding of spinal pathophysiology is of paramount importance. The spine has three principal biomechanical roles; namely load bearing, mobility, and protection of the neural elements. With obesity on the rise and the ageing population, lumbar spinal disease is set to become increasingly prevalent. This chapter outlines the three key pathophysiological concepts underpinning lumbar spinal disease: spinal function, the motion segment, and spinopelvic balance. In addition, the clinical features pertaining to these common pathological processes are described and the best available evidence guiding treatment is discussed.

scholarly journals Impact of Preoperative Total Knee Arthroplasty on Radiological and Clinical Outcomes of Spinal Fusion for Concurrent Knee Osteoarthritis and Degenerative Lumbar Spinal Diseases

2021 ◽  
Vol 10 (19) ◽  
pp. 4475
Author(s):  
Hong Jin Kim ◽  
Jae Hyuk Yang ◽  
Dong-Gune Chang ◽  
Seung Woo Suh ◽  
Hoon Jo ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Osteoarthritis ◽  
Spinal Fusion ◽  
Clinical Outcomes ◽  
Knee Arthroplasty ◽  
Spinal Diseases ◽  
Spinal Disease ◽  
Spinopelvic Alignment ◽  
Total Knee ◽  
Lumbar Spinal

Concurrent knee osteoarthritis (KOA) and degenerative lumbar spinal disease (LSD) has increased, but the total knee arthroplasty (TKA) effect on degenerative LSD remains unclear. The aim of this study was to retrospectively analyze to compare radiological and clinical outcomes between spinal fusion only and preoperative TKA with spinal fusion for the patients with concurrent KOA and degenerative LSD. A total of 72 patients with concurrent KOA and degenerative LSDs who underwent spinal fusion at less than three levels were divided in two groups: non-TKA group (n = 50) and preoperative TKA group (n = 22). Preoperative lumbar lordosis (LL) was significantly lower in the preoperative TKA group than the non-TKA group (p < 0.05). Significantly higher preoperative pelvic incidence (PI), PI/LL mismatch, and pelvic tilt (PT) occurred in preoperative TKA group than non-TKA group (all p < 0.05). There was significant improvement of postoperative Oswestry Disability Index and leg Visual Analog Scale in the preoperative TKA group (all p < 0.01). Preoperative TKA could be a benefit for in proper correction of sagittal spinopelvic alignment by spinal fusion. Therefore, preoperative TKA could be considered a preceding surgical option for patients with severe sagittal spinopelvic parameters in concurrent KOA and degenerative LSD.

scholarly journals Stuburo juosmeninės dalies kanalo stenozė: klinikinė anatomija, diagnostika (I dalis)

2003 ◽  
Vol 1 (4) ◽  
pp. 0-0
Author(s):  
Valentinas Uvarovas ◽  
Giedrius Kvederas ◽  
Igoris Šatkauskas
Keyword(s):  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Nerve Root ◽  
Cauda Equina ◽  
Neurogenic Claudication ◽  
Clinical Anatomy ◽  
Ageing Population ◽  
Imaging Studies ◽  
Pathologic Features ◽  
Lumbar Spinal

Valentinas Uvarovas, Giedrius Kvederas, Igoris ŠatkauskasVilniaus universiteto Ortopedijos, traumatologijos ir plastinės chirurgijos klinikaVilniaus greitosios pagalbos universitetinė ligoninėŠiltnamių g. 29, LT-2043 VilniusEl paštas: [email protected] Pasaulyje ženkliai auga pagyvenusių žmonių populiacija, kartu daugėja ligų, kuriomis dažniausiai sergama perkopus į antrą gyvenimo pusę. Viena iš tokių ligų yra stuburo kanalo stenozė, t. y. susiaurėjimas. Dažniausia stuburo kanalo stenozės priežastis yra su amžiumi progresuojantys stuburo degeneraciniai pokyčiai. Ne visada arklio uodegos ar nervų šaknelių spaudimas sukelia dirginimo simptomus, tačiau progresuojant patologiniams anatominiams ir fiziologiniams pokyčiams gali išryškėti klinika. Kartais rentgenologiniai duomenys neatspindi klinikos, todėl labai svarbu tiksliai įvertinti ligos simptomus, jų eigą bei rentgenologinius duomenis, kad būtų pasirinkta tinkama gydymo taktika. Prasminai žodžiai: stuburo kanalo stenozė, neurogeninė klaudikacija, nervinės šaknelės, arklio uodega Lumbar spinal stenosis: clinical anatomy, diagnostics Valentinas Uvarovas, Giedrius Kvederas, Igoris Šatkauskas Lumbar spinal stenosis remains one of the most frequently encountered clinical important degenerative spinal disorders in the ageing population. Spinal stenosis is a narrowing or stricture of the spinal canal. Cauda equina and nerve root compression are noted in many asymptomatic individuals. The spinal degenerative process associated with ageing leads to pathoanatomical and pathophysiological changes with occasional clinical consequences. With progressive degenerative changes and compression, spinal stenosis may become symptomatic, although the severity of the symptoms is not necessarily associated with the magnitude of the compression seen on imaging studies. A thorough understanding of the etiology, pathologic features and a correlation between the symptoms and the precise location of the thecal sac and nerve root are very important in evaluating the imaging studies and planning appropriate treatment. Keywords: lumbar spinal stenosis, neurogenic claudication, spinal nerve root, cauda equina

scholarly journals Have Studies that Measure Lumbar Kinematics and Muscle Activity Concurrently during Sagittal Bending Improved Understanding of Spinal Stability and Sub-System Interactions? A Systematic Review

Healthcare ◽  
2018 ◽  
Vol 6 (3) ◽  
pp. 112 ◽  
Author(s):  
Alister du Rose
Keyword(s):  
Neural Control ◽  
Small Sample ◽  
Spinal Stability ◽  
Functional Movement ◽  
Multiple Systems ◽  
Complex Interactions ◽  
Motion Segment ◽  
Small Sample Sizes ◽  
New Research ◽  
Lumbar Spinal

In order to improve understanding of the complex interactions between spinal sub-systems (i.e., the passive (ligaments, discs, fascia and bones), the active (muscles and tendons) and the neural control systems), it is necessary to take a dynamic approach that incorporates the measurement of multiple systems concurrently. There are currently no reviews of studies that have investigated dynamic sagittal bending movements using a combination of electromyography (EMG) and lumbar kinematic measurements. As such it is not clear how understanding of spinal stability concepts has advanced with regards to this functional movement of the spine. The primary aim of this review was therefore to evaluate how such studies have contributed to improved understanding of lumbar spinal stability mechanisms. PubMed and Cochrane databases were searched using combinations of the keywords related to spinal stability and sagittal bending tasks, using strict inclusion and exclusion criteria and adhering to PRISMA guidelines. Whilst examples of the interactions between the passive and active sub-systems were shown, typically small sample sizes meant that results were not generalizable. The majority of studies used regional kinematic measurements, and whilst this was appropriate in terms of individual study aims, the studies could not provide insight into sub-system interaction at the level of the spinal motion segment. In addition, the heterogeneity in methodologies made comparison between studies difficult. The review suggests that since Panjabi’s seminal spinal control papers, only limited advancement in the understanding of these theories has been provided by the studies under review, particularly at an inter-segmental level. This lack of progression indicates a requirement for new research approaches that incorporate multiple system measurements at a motion segment level.

Clinical features and surgical outcomes of lumbar spinal stenosis in patients aged 80 years or older: a multi-center retrospective study

2013 ◽  
Vol 133 (9) ◽  
pp. 1243-1248 ◽  
Author(s):  
Yoshiro Nanjo ◽  
Hideki Nagashima ◽  
Toshiyuki Dokai ◽  
Yuki Hamamoto ◽  
Hirokazu Hashiguchi ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Spinal Stenosis ◽  
Clinical Features ◽  
Lumbar Spinal Stenosis ◽  
Surgical Outcomes ◽  
Lumbar Spinal

scholarly journals What Is the Role of Epidural Steroid Injections in Lumbar Spinal Disease with Moderate Disability?

2016 ◽  
Vol 4;19 (4;5) ◽  
pp. 293-298
Author(s):  
Jae-Young Hong
Keyword(s):  
Steroid Injection ◽  
Radicular Pain ◽  
Epidural Steroid Injection ◽  
Spinal Disease ◽  
Steroid Injections ◽  
Epidural Steroid Injections ◽  
Pain Scores ◽  
One Year ◽  
Lumbar Spinal ◽  
Epidural Steroid

Epidural steroid injections have been gaining popularity as an alternative to surgical treatment of radicular pain with associated spinal derangement. To determine the effectiveness and indications of lumbar epidural steroid injections in patients with or without surgery, we performed a prospective observational study. We gathered data from 262 degenerative short-segment spinal disease patients (affected at one or 2 levels) with greater than 12 weeks of medication-resistant radicular pain without neurological deficits but with moderate disability (visual analog scale < 6.5; Oswestry Disability Index < 35). All patients received initial fluoroscopically guided transforaminal epidural steroid injections of the affected vertebral level(s) corresponding to their symptoms. Those with inadequate responses or who wanted subsequently surgery underwent decompression surgery. Clinical and demographic characteristics were assessed to compare the differences between the groups. Results: Of the 262 patients who received epidural steroid injections, 204 did not have operations for up to one year. However, 58 patients experienced inadequate relief of pain or wanted operations and therefore underwent surgery. At baseline, the 2 groups had similar mean disability indices and pain scores, as well as gender ratios, ages, and durations of symptoms (P > 0.05). In the patients who underwent surgery, the mean disability and pain scores were not significantly decreased after injection compared to those in the injection-alone group, although the scores for the injection plus surgery patients decreased significantly after surgery (P < 0.05). In contrast, patients who underwent epidural steroid injection alone experienced a significant decrease in disability and pain after injection, and that persisted up to one year of follow-up (P < 0.05). Epidural steroid injection can decrease the pain and disability in the majority of a moderate disability group for up to one year, although a significant number of patients underwent surgery regardless of injection. We recommend epidural steroid injection as a first-line treatment in patients with moderate disability that can be converted to surgery without significant delay. Key words: Epidural steroid injection, spinal surgery, lumbar spinal disease, lumbar radiculopathy, lumbar radicular pain

Correlation between Clinical Features and MRI Findings in One Level Lumbar Spinal Stenosis

1999 ◽  
Vol 34 (3) ◽  
pp. 541 ◽  
Author(s):  
Sung Soo Chung ◽  
Chong Suh Lee ◽  
Saeng Guk Lee ◽  
Hee Joon Choi ◽  
Bong Jin Park
Keyword(s):  
Spinal Stenosis ◽  
Clinical Features ◽  
Lumbar Spinal Stenosis ◽  
Mri Findings ◽  
Lumbar Spinal
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