scholarly journals Exercise Therapy Using the Lumbar-Type Hybrid Assistive Limb Ameliorates Locomotive Function after Lumbar Fusion Surgery in an Elderly Patient

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Yoshihiro Yasunaga ◽  
Kousei Miura ◽  
Masao Koda ◽  
Toru Funayama ◽  
Hiroshi Takahashi ◽  
...  
Keyword(s):  
Elderly Patient ◽  
Exercise Therapy ◽  
Lumbar Fusion ◽  
Adjacent Segment ◽  
Fusion Surgery ◽  
Stand Test ◽  
Lumbar Fusion Surgery ◽  
Sit To Stand ◽  
First Case ◽  
Hybrid Assistive Limb

The number of elderly people who undergo lumbar fusion surgery (LFS) has been increasing. Postoperative rehabilitation for them can be problematic due to lumbar stiffness. This is the first case report describing exercise therapy using the lumbar-type hybrid assistive limb (HAL) after multiple LFS in an elderly patient. An 83-year-old man underwent LFS at L4-S1. Additional fusion surgery at L2-3 for adjacent segment disease was performed 2 years after the primary surgery. Although the patient’s leg pain declined, he had severe locomotive dysfunction at 3 months after his final surgery. He started exercise therapy using the lumbar-type HAL including sit-to-stand training and squat training 4 months after his final surgery. He performed 3 sets of 20 sit-to-stand and 20 squat repetitions with adequate rests in between sets. The HAL training was safely conducted every day for 12 weeks without adverse event. Timed up and go test (TUG), 1-minute sit to stand test (1MSTS), one-leg stand test (OLST), and Berg balance scale (BBS) were assessed as locomotive function measurement. Before HAL therapy, TUG, 1MSTS, OLST, and BBS were 18.1 sec, 20 times, less than 1 sec, and 47, respectively. He could not walk without assistance. After the exercise therapy with the lumbar-type HAL, his locomotive function dramatically improved. TUG, 1MSTS, OLST, and BBS were 12.2 sec, 25 times, 3.9 sec, and 52, respectively. Moreover, the patient could walk 60 meters continuously without assistance. The unique characteristics of the lumbar-type HAL to prevent the lumbar overload and assist the voluntary hip joint motion during exercise therapy may be effective for this patient with lumbar stiffness after LFS. Sit-to-stand training and squat training using the lumbar-type HAL are promising options to improve locomotive function in elderly patients after LFS.

scholarly journals A case of pituitary apoplexy following posterior lumbar fusion surgery

2015 ◽  
Vol 23 (5) ◽  
pp. 598-601 ◽  
Author(s):  
Akın Akakın ◽  
Baran Yılmaz ◽  
Murat Şakir Ekşi ◽  
Türker Kılıç
Keyword(s):  
Pituitary Adenoma ◽  
Pituitary Apoplexy ◽  
Lumbar Fusion ◽  
Rare Complication ◽  
Interdisciplinary Approach ◽  
Electrolyte Imbalance ◽  
Fusion Surgery ◽  
Posterior Lumbar Fusion ◽  
Lumbar Fusion Surgery ◽  
First Case

Pituitary adenoma is a common primary brain neoplasm. Pituitary apoplexy (PA) is a rare complication of pituitary adenoma and occurs as the result of sudden tumor growth and following different comorbidities. The authors describe the first case of PA following posterior lumbar fusion surgery performed while the patient was prone. In patients with a preexisting pituitary adenoma, thorough clinical and laboratory investigations should be conducted using an interdisciplinary approach before any planned surgery. In unknown cases of pituitary adenoma, PA should be kept in mind for the differential diagnosis in a case with headache, nausea, vomiting, ophthalmoplegia, visual loss, and electrolyte imbalance concurrent with an ongoing disease state.

scholarly journals Risk factors for adjacent segment degeneration after posterior lumbar fusion surgery in treatment for degenerative lumbar disorders: a meta-analysis

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Tao Wang ◽  
Wenyuan Ding
Keyword(s):  
Risk Factors ◽  
Lumbar Fusion ◽  
Meta Analysis ◽  
Adjacent Segment Degeneration ◽  
Cochrane Library ◽  
Adjacent Segment ◽  
Fusion Surgery ◽  
Posterior Lumbar Fusion ◽  
Lumbar Fusion Surgery ◽  
History Of

Abstract Study design A meta-analysis. Objective We performed a meta-analysis to explore the incidence and risk factors of adjacent segment degeneration (ASD) after posterior lumbar fusion surgery. Methods An extensive search of the literature was performed in English database of PubMed, Embase, and Cochrane Library, and Chinese database of CNKI and WANFANG (up to May 2020). We collected factors including demographic data, surgical factor, and sagittal parameters. Data analysis was conducted with RevMan 5.3 and STATA 12.0. Results Finally, 19 studies were included in the final analysis. In our study, the rate of ASD after posterior lumbar fusion surgery was 18.6% (540 of 2896). Our data also showed that mean age, body mass index (BMI), the history of smoking and hypertension, preoperative adjacent disc degeneration, long-segment fusion, preoperative superior facet violation, high lumbosacral joint angle, pre- and post-operative L1-S1 sagittal vertical axis (SVA), post-operative lumbar lordosis (LL), and preoperative pelvic incidence (PI) were associated with the development of ASD. However, gender, history of diabetes, bone mineral density (BMD), preoperative Oswestry Disability Index (ODI) and Japanese Orthopedic Association (JOA), the type of fusion (PLIF vs TLIF), type of bone graft (auto- vs allograft), fusion to S1(vs non-fusion to S1), diagnose (lumbar disc herniation, lumbar spinal stenosis, lumbar spondylolisthesis), preoperative pelvic tilt (PT), LL and sacral slope (SS), post-operative SS, PT and PI were not associated with the development of ASD. Conclusions In our study, many factors were correlated with the risk of ASD after posterior lumbar fusion surgery. We hope this article can provide a reference for spinal surgeons in treatment for lumbar degenerative diseases.

The influence of facet joint orientation and tropism on the stress at the adjacent segment after lumbar fusion surgery: a biomechanical analysis

2015 ◽  
Vol 15 (8) ◽  
pp. 1841-1847 ◽  
Author(s):  
Ho-Joong Kim ◽  
Kyoung-Tak Kang ◽  
Juhyun Son ◽  
Choon-Ki Lee ◽  
Bong-Soon Chang ◽  
...  
Keyword(s):  
Facet Joint ◽  
Lumbar Fusion ◽  
Biomechanical Analysis ◽  
Adjacent Segment ◽  
Joint Orientation ◽  
Fusion Surgery ◽  
Lumbar Fusion Surgery

Lumbar Fusion Surgery for Patients With Back Pain and Degenerative Disc Disease: An Observational Study From the Canadian Spine Outcomes and Research Network

2021 ◽  
pp. 219256822098547
Author(s):  
Nathan Evaniew ◽  
Ganesh Swamy ◽  
W. Bradley Jacobs ◽  
Jacques Bouchard ◽  
Roger Cho ◽  
...  
Keyword(s):  
Back Pain ◽  
Degenerative Disc Disease ◽  
Short Form ◽  
Lumbar Fusion ◽  
Research Network ◽  
Disc Disease ◽  
Fusion Surgery ◽  
Degenerative Disc ◽  
Lumbar Fusion Surgery ◽  
Related Quality

Study Design: Uncontrolled retrospective observational study. Objectives: Surgery for patients with back pain and degenerative disc disease is controversial, and studies to date have yielded conflicting results. We evaluated the effects of lumbar fusion surgery for patients with this indication in the Canadian Spine Outcomes and Research Network (CSORN). Methods: We analyzed data that were prospectively collected from consecutive patients at 11 centers between 2015 and 2019. Our primary outcome was change in patient-reported back pain at 12 months of follow-up, and our secondary outcomes were satisfaction, disability, health-related quality of life, and rates of adverse events. Results: Among 84 patients, we observed a statistically significant improvement of back pain at 12 months that exceeded the threshold of Minimum Clinically Important Difference (MCID) (mean change -3.7 points, SD 2.6, p < 0.001, MCID = 1.2; 77% achieved MCID), and 81% reported being “somewhat” or “extremely” satisfied. We also observed improvements of Oswestry Disability Index (-17.3, SD 16.6), Short Form-12 Physical Component Summary (10.3, SD 9.6) and Short Form-12 Mental Component Summary (3.1, SD 8.3); all p < 0.001). The overall rate of adverse events was 19%. Conclusions: Among a highly selective group of patients undergoing lumbar fusion surgery for degenerative disc disease, most experienced a clinically significant improvement of back pain as well as significant improvements of disability and health-related quality of life, with high satisfaction at 1 year of follow-up. These findings suggest that surgery for this indication may provide some benefit, and that further research is warranted.

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