Acupuncture for Patients with Lumbar Spinal Stenosis: A Randomised Pilot Trial

2016 ◽  
Vol 34 (4) ◽  
pp. 267-274 ◽  
Author(s):  
Kun Hyung Kim ◽  
Yu Ri Kim ◽  
Seung Kug Baik ◽  
Seung Hee Noh ◽  
Dae Hun Kim ◽  
...  
Keyword(s):  
Usual Care ◽  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Pilot Trial ◽  
Acupuncture Group ◽  
Self Management ◽  
Control Group ◽  
Registration Number ◽  
Secondary Outcomes ◽  
Lumbar Spinal

Objective To assess the safety and feasibility of acupuncture for participants with symptomatic lumbar spinal stenosis (LSS) in a pilot study. Methods 50 participants with a clinical and radiological diagnosis of LSS were randomised to receive acupuncture combined with usual care (acupuncture group), or usual care alone (control group). Participants in the acupuncture group were offered 12–16 sessions of manual acupuncture±electroacupuncture over 6 weeks and maintained their usual self-management. The control group was provided with physical therapy as required and maintained their usual self-management. The primary outcome was the change in back-specific functional status, as measured by the Oswestry disability index (ODI) at the 3-month follow-up. Secondary outcomes included symptoms and other relevant domains. Outcome assessors were not blinded. Results 39 participants (78%) completed the trial with 524 treatment visits. There were no significant differences between the two groups in back-specific function (ODI: mean difference −2.5, 95% CI −8.9 to 3.8). Pain in the back and/or leg showed small improvements at 3 months, while there were no significant differences in other secondary outcomes. The total number of adverse events was 61 (12% of 524 treatment visits). All but one were minor and transient. The one severe adverse event was deemed to be unrelated to acupuncture. Conclusions The study was feasible. Acupuncture combined with usual care did not confer significant functional improvements over usual care alone. Further randomised trials with adequate sample sizes and outcome assessor blinding are warranted to evaluate the role of acupuncture for LSS. Trial Registration Number NCT01987622.

scholarly journals Efficacy and safety of percutaneous transforaminal endoscopic discectomy in the treatment of lumbar spinal stenosis combined with osteoporosis

2019 ◽  
Vol 65 (6) ◽  
pp. 779-785
Author(s):  
Xiaobin Gu ◽  
Wenhui Zhu ◽  
Haiyi He ◽  
Zili Wang ◽  
Shaolong Ding ◽  
...  
Keyword(s):  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Adverse Reactions ◽  
Leg Pain ◽  
Control Group ◽  
Efficacy And Safety ◽  
Significant Difference ◽  
Endoscopic Discectomy ◽  
Percutaneous Transforaminal Endoscopic Discectomy ◽  
Lumbar Spinal

SUMMARY OBJECTIVE: To investigate the efficacy and safety of percutaneous transforaminal endoscopic discectomy (PTED) in the treatment of lumbar spinal stenosis (LSS) combined with osteoporosis. METHODS: Eighty patients with LSS combined with osteoporosis were divided into a control and PTED group, which received conventional transforaminal lumbar interbody fusion and PTED, respectively. The surgical indications, incision visual analogue scale (VAS), lumbar and leg pain VAS, lumbar Japanese Orthopaedic Association (JOA) and Oswestry disability index (ODI) scores, bone mineral density (BMD), and adverse reactions were observed. RESULTS: Compared with the control group, in the PTED group, the operation time, bleeding loss and hospitalization duration, incision VAS scores at postoperative 12, 24 and 48 h and lumbar and leg pain VAS and lumbar ODI scores on postoperative 6 months were significantly decreased (P < 0.01), and the lumbar JOA score on postoperative 6 months was significantly increased (P < 0.05). There was no significant difference in BMD between two groups (P > 0.05). Compared with the control group, in the PTED group, the total effective rate was significantly higher (P < 0.05), and the incidence of adverse reactions was significantly lower (P < 0.05). CONCLUSIONS: PTED is safe and effective in the treatment of LSS combined with osteoporosis.

scholarly journals Treatment for Lumbar Spinal Stenosis Secondary to Ligamentum Flavum Hypertrophy Using Percutaneous Endoscopy through Interlaminar Approach: A Retrospective Study

2020 ◽  
Author(s):  
Yi Liu ◽  
Yingjie Qi ◽  
Diarra Mohamed Diaty ◽  
Guanglei Zheng ◽  
Xiaoqiang Shen ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Disease Duration ◽  
Ligamentum Flavum ◽  
Leg Pain ◽  
Control Group ◽  
Interlaminar Approach ◽  
Lumbar Spinal ◽  
Percutaneous Endoscopy

Abstract Background This paper is to first describe percutaneous endoscopy in the treatment of lumbar spinal stenosis secondary to ligamentum flavum hypertrophy targetedly. To investigate the efficacy and safety of percutaneous endoscopy in the treatment of this kind of lumbar spinal stenosis in elderly patients. Method: A retrospective analysis of 40 elderly patients with lumbar spinal stenosis secondary to ligamentum flavum hypertrophy admitted between January 2016 and January 2018 was performed. According to different surgical methods, they were divided into two groups: the control group and the endoscopy group (interlaminar approach), 20 people per group. There were 9 males and 11 females in the control group; the age of patients was 65.65 ± 4.44years, and the average disease duration was 4.55 ± 1.85 years. Besides, There were 10 males and 10 females in the endoscopy group; the age of patients was 67.30 ± 4.23years, and the average disease duration was 4.95 ± 2.04 years. Collect and count surgical-related indicators, preoperative and postoperative radiologic findings, incision visual analogue scale (VAS), lumbar and leg pain VAS, lumbar Japanese Orthopaedic Association (JOA) and Oswestry disability index (ODI) scores of all patients. Result A series of surgical indicators (including the operation time, the quantity of bleeding and postoperative hospital stay) in the endoscopy group was significantly lower than that in the control group (p < 0.05). The incision VAS score in the endoscopy group was also significantly lower than that in the control group at each time after surgery (p < 0.05). Besides, compared with the control group, in the endoscopy group, the leg pain VAS score and lumbar ODI score after surgery were significantly decreased (p < 0.05). Compared with the control group, in the endoscopy group, the lumbar JOA score was significantly higher (p < 0.05). Conclusion Percutaneous endoscopic technique is a small trauma, quick recovery, safe and effective minimally invasive surgery for patients with lumbar spinal stenosis secondary to ligamentum flavum hypertrophy.

scholarly journals Facet Tropism and Orientation: Risk Factors for Degenerative Lumbar Spinal Stenosis

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Janan Abbas ◽  
Natan Peled ◽  
Israel Hershkovitz ◽  
Kamal Hamoud
Keyword(s):  
Risk Factors ◽  
Lumbar Spine ◽  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Control Group ◽  
Degenerative Lumbar Spinal Stenosis ◽  
Lower Lumbar Spine ◽  
Lumbar Spinal ◽  
Lower Lumbar ◽  
Facet Tropism

The aim of this study is to establish whether facet tropism (FT) and orientation (FO) are associated with degenerative lumbar spinal stenosis (DLSS). A retrospective computerized tomography (CT) study including 274 individuals was divided into two groups: control (82 males and 81 females) and stenosis (59 males and 52 females). All participants have undergone high-resolution CT scan of the lumbar spine in the same position. FT and FO were measured at L1-2 to L5-S1. Significant sagittal FO was noted in the stenosis males (L2-3 to L4-5) and females (L2-3 to L5-S1) compared to the controls. The prevalence of FT was remarkably greater in the stenosis males (L4-5, L5-S1) and females (L3-4, L5-S1) compared to their counterparts in the control group. Our results also showed that FT (L3-4 to L5-S1) increases approximately 2.9 times the likelihood for DLSS development. This study indicates that FO and FT in the lower lumbar spine are significantly associated with DLSS.

scholarly journals Surgical treatment for lumbar spinal stenosis: a single-blinded randomized controlled trial

2021 ◽  
Vol 61 (1) ◽  
Author(s):  
Luiz Claudio Lacerda Rodrigues ◽  
Jamil Natour
Keyword(s):  
Surgical Treatment ◽  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Likert Scale ◽  
Control Group ◽  
Walk Test ◽  
Medium Term ◽  
Sf 36 ◽  
Significant Difference ◽  
Lumbar Spinal

Abstract Objective To evaluate the effectiveness of surgery for the management of patients with symptomatic lumbar spinal stenosis. Methods Sixty-three patients with lumbar canal stenosis were randomized into two groups: the intervention group (IG) and control group (CG). IG patients underwent surgery and both groups participated in the same physical therapy program twice a week for a period of 12 weeks and were followed up at 1 year. The primary endpoint was visual analogue scale for pain, and the secondary endpoints were function (6-min walk test, Roland Morris and Oswestry questionnaires), quality of life (SF-36 questionnaire) and satisfaction with treatment (Likert scale). Results No significant difference between groups was observed for pain over time (p = 0.145). Significant differences between groups, in favor of the IG, were observed for the Oswestry score (p = 0.006) and vitality domain score of the SF-36 (p = 0.047). Function in the Roland Morris and 6-min walk test and the role of the physical domain of SF-36 also showed significant differences between the groups; however, these differences occurred due to a worsening of the IG in the short term, and the medium-term. The Likert scale demonstrated greater satisfaction with the IG treatment compared to control group. Conclusions Lumbar stenosis surgery did not improve pain in short and medium terms. Function and vitality were better in the group that underwent surgery in the medium term, and patients were more satisfied with the surgical treatment. Trial registration Clinicaltrials.gov (NCT02879461).

scholarly journals Effectiveness of an exercise-based prehabilitation program for patients awaiting surgery for lumbar spinal stenosis: a randomized clinical trial

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Andrée-Anne Marchand ◽  
Mariève Houle ◽  
Julie O’Shaughnessy ◽  
Claude-Édouard Châtillon ◽  
Vincent Cantin ◽  
...  
Keyword(s):  
Usual Care ◽  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Postoperative Recovery ◽  
Perioperative Outcomes ◽  
Low Back ◽  
Post Intervention ◽  
Supervised Exercise ◽  
Significant Difference ◽  
Lumbar Spinal

AbstractLumbar spinal stenosis is the most common reason for spine surgery in older adults, but the effects of prehabilitation on perioperative outcomes among these patients have not been investigated. This study aims to evaluate the effectiveness of a preoperative exercise-based intervention program compared with usual care on the improvement of clinical status, physical capacities and postoperative recovery of patients awaiting surgery for lumbar spinal stenosis. Sixty-eight participants were randomised to receive either a 6-week supervised exercise-based prehabilitation program or hospital usual care. The outcomes included both clinical and physical measures. Data collection occurred at post-intervention, and 6 weeks, 3- and 6-months post-surgery. Significant but small improvements were found in favour of the experimental group at the post-intervention assessment for pain intensity, lumbar spinal stenosis-related disability, lumbar strength in flexion, low back extensor muscles endurance, total ambulation time, and sit to stand performance. A significant difference in favor of the intervention group was found starting at the 3-month postoperative follow-up for low back-related disability. No adverse events were reported. Exercise-based prehabilitation did not improve short-term postoperative recovery in patients with lumbar spinal stenosis.

scholarly journals Pedicle Morphometry Variations in Individuals with Degenerative Lumbar Spinal Stenosis

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Janan Abbas ◽  
Natan Peled ◽  
Israel Hershkovitz ◽  
Kamal Hamoud
Keyword(s):  
General Population ◽  
Sex Ratio ◽  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Lumbar Vertebrae ◽  
Control Group ◽  
Degenerative Lumbar Spinal Stenosis ◽  
Males And Females ◽  
Lumbar Spinal ◽  
Age Range

The aim of this study was to compare pedicle dimensions in degenerative lumbar spinal stenosis (DLSS) with those in the general population. A retrospective computerized tomography (CT) study for lumbar vertebrae (L1 to L5) from two sample populations was used. The first included 165 participants with symptomatic DLSS (age range: 40-88 years, sex ratio: 80 M/85 F), and the second had 180 individuals from the general population (age range: 40-99 years, sex ratio: 90 M/90 F). Both males and females in the stenosis group manifested significantly greater pedicle width than the control group at all lumbar levels (P<0.05). In addition, pedicle heights for stenosis females were remarkably smaller on L4 and L5 levels compared to their counterparts in the control group (P<0.001). Males have larger pedicles than females for all lumbar levels (P<0.001). Age and BMI did not demonstrate significant association with pedicle dimensions. Our outcomes indicate that individuals with DLSS have larger pedicle widths than the control group. More so, pedicle dimensions are gender-dependent but independent of age and BMI.

scholarly journals Is Lumbosacral Transitional Vertebra Associated with Degenerative Lumbar Spinal Stenosis?

2019 ◽  
Vol 2019 ◽  
pp. 1-7
Author(s):  
Janan Abbas ◽  
Natan Peled ◽  
Israel Hershkovitz ◽  
Kamal Hamoud
Keyword(s):  
Sex Ratio ◽  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Control Group ◽  
Lumbar Region ◽  
Degenerative Lumbar Spinal Stenosis ◽  
Transitional Vertebra ◽  
Lumbosacral Transitional Vertebra ◽  
Lumbar Spinal ◽  
Age Range

The aim of this study was to shed light on the association between lumbosacral transitional vertebra (LSTV) and degenerative lumbar spinal stenosis (DLSS). A cross-sectional retrospective study was performed on 165 individuals that were diagnosed with clinical picture of DLSS (age range: 40-88 years; sex ratio: 80M/85F) and 180 individuals without DLSS related symptoms (age range: 40-99 years; sex ratio: 90M/90F). All participants had undergone high-resolution CT scan for the lumbar region in the same position. We also used the volume rendering method to obtain three-dimensional CT images of the lumbosacral area. Both males and females in the stenosis group manifest greater prevalence of LSTV than their counterparts in the control group (P<0.001). Furthermore, the presence of LSTV increases the likelihood of degenerative spinal stenosis (odds ratio= 3.741, P<0.001). In the control group, LSTV was more common in males, and sacral slope angle of males was significantly greater in LSTV group compared to non-LSTV. This study indicates that LSTV was significantly associated with symptomatic DLSS.

scholarly journals Effects of Nasal Calcitonin vs. Oral Gabapentin on Pain and Symptoms of Lumbar Spinal Stenosis: A Clinical Trial Study

2016 ◽  
Vol 9 ◽  
pp. CMAMD.S39938 ◽  
Author(s):  
Kaveh Haddadi ◽  
Leila Asadian ◽  
Ahdie Isazade
Keyword(s):  
Clinical Trial ◽  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Salmon Calcitonin ◽  
Control Group ◽  
Neurogenic Claudication ◽  
Nasal Calcitonin ◽  
Significant Difference ◽  
Nasal Salmon Calcitonin ◽  
Lumbar Spinal

Lumbar spinal stenosis (LSS) is a chronic and prevalent disease that occurs in 10.8% of the general population, mostly in old age. We designed the first clinical trial study to compare the effects of administering the nasal salmon calcitonin spray and gabapentin in patients with LSS. In this clinical trial, 90 patients with symptoms of neurogenic claudication and magnetic resonance imaging-proven LSS were randomly assigned to nasal salmon calcitonin, gabapentin, or placebo treatments for eight weeks (30 participants in each group). This was followed by a washout period of four weeks. After three months of study and after four weeks off the prescription, mean values of Oswestry Disability Index in the calcitonin, gabapentin, and control groups were 23 ± 12.05, 32 ± 16.08, and 38 ± 22.09, respectively ( P ≤ 0.05, calcitonin group vs. gabapentin group, and P ≤ 0. 001, calcitonin group vs. control group with respect to pretreatment scores). Thus, three months after the treatment, although most of the patients in the control group had a satisfactory period of improvement, the improvement in the calcitonin group was more than the other two groups with a significant difference ( P ≤ 0.05 when compared to gabapentin group and P ≤ 0.01 when compared to placebo group). We revealed that the 200 International Unit (IU) and nasal calcitonin spray daily are more effective compared to 300 mg gabapentin three times per day and the placebo effect for eight weeks of treatment of symptoms of patients with LSS.

scholarly journals Diabetes Mellitus, a New Risk Factor for Lumbar Spinal Stenosis: A Case–Control Study

2016 ◽  
Vol 9 ◽  
pp. CMED.S39035 ◽  
Author(s):  
Leila Asadian ◽  
Kaveh Haddadi ◽  
Mohsen Aarabi ◽  
Amirhossein Zare
Keyword(s):  
Diabetes Mellitus ◽  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Case Control Study ◽  
Control Group ◽  
Disk Herniation ◽  
Lumbar Disk Herniation ◽  
Lumbar Disk ◽  
Lumbar Spinal ◽  
Control Study

Objectives This study aimed to determine the prevalence of diabetes mellitus in patients with spinal stenosis and lumbar vertebral disk degeneration, and the correlation of diabetes with these diseases. Study Design This is a cross-sectional study. Methods This case–control study was performed during 2012–2014 with 110 patients suffering from lumbar spinal stenosis and 110 patients with lumbar disk herniation, who were diagnosed using clinical and radiological evidences. Additionally, 110 participants who were referred to the clinic and did not show clinical signs of degenerative diseases of the lumbar spine entered the study as a control group. Demographic data and medical histories of the patients were collected using checklists. Results A total of 50 patients (15.2%) were diagnosed with diabetes, which comprised 32 (29.1%) in the stenosis group, 7 (6.4%) in the lumbar disk herniation group, and 11 (10%) in the control group. The prevalence of diabetes in women with spinal stenosis and women with lumbar disk herniation was 35.9% and 10.3%, respectively, whereas prevalence of diabetes in women was 10.9% in the control group. This difference was statistically significant in the spinal stenosis group in comparison with the controls ( P < 0.0001). Conversely, no significant difference was found in men. Conclusions There is an association between diabetes and lumbar spinal stenosis. Diabetes mellitus may be a predisposing factor for the development of lumbar spinal stenosis.

Clinical usefulness of assessing lumbar somatosensory evoked potentials in lumbar spinal stenosis

2009 ◽  
Vol 11 (1) ◽  
pp. 71-78 ◽  
Author(s):  
Xinyu Liu ◽  
Shunsuke Konno ◽  
Masabumi Miyamoto ◽  
Yoshikazu Gembun ◽  
Gen Horiguchi ◽  
...  
Keyword(s):  
Evoked Potentials ◽  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Somatosensory Evoked Potentials ◽  
Clinical Usefulness ◽  
Control Group ◽  
Vas Score ◽  
Vas Scores ◽  
The Mean ◽  
Lumbar Spinal

Object The aim of this retrospective study was to evaluate the clinical usefulness of assessing lumbar somatosensory evoked potentials (SSEPs) in central lumbar spinal stenosis (LSS). Methods The latencies of lumbar SSEPs were recorded in 40 patients with central LSS, including 16 men and 24 women. The mean age of the patients was 67.3 ± 7.4 years. The diagnosis was LSS in 23 cases and LSS associated with degenerative spondylolisthesis in 17 cases. The average duration of symptoms was 43.8 ± 51.2 months. Twenty-two cases had bilateral and 18 cases had unilateral leg symptoms. Thirty-seven cases were associated with neurogenic intermittent claudication and the mean walking distance of patients with this condition was 246.8 ± 232.7 m. The mean Japanese Orthopedic Association scale score, as well as the visual analog scale (VAS) scores of low-back pain, leg pain, and numbness, were 16.5 ± 3.5, 6.0 ± 2.5, 6.9 ± 2.1, and 7.8 ± 2.2, respectively. The minimal cross-sectional area of the dural sac on MR imaging was 0.44 ± 0.21 cm2. Thirty-nine cases of cervical spondylotic myelopathy without lumbar and peripheral neuropathy were chosen as the control group. Results The latencies of lumbar SSEPs in patients with LSS and in the control group were 23.0 ± 2.0 ms and 21.6 ± 1.9 ms, respectively. There was a statistically significant difference between the LSS and control groups (p < 0.05). The latency of lumbar SSEPs was significant correlated with the VAS score of leg numbness (p < 0.05). The latency of lumbar SSEPs in LSS was clearly delayed when the VAS score of leg numbness was ≥ 8 (p < 0.05). Conclusions Lumbar SSEPs are able to detect neurological deficit in the lumbar area effectively, and they can reflect part of the subjective severity of sensory disturbance (numbness) in LSS. Both lumbar SSEPs and VAS scores of leg numbness may be useful for clinical evaluation in patients with LSS.

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