Decompression of Lumbar Spinal Stenosis and Stabilization with Knodt Rods in the Elderly Patient

Neurosurgery ◽  
1990 ◽  
Vol 26 (5) ◽  
pp. 758-763 ◽  
Author(s):  
Frances K. Conley ◽  
Carol T. Cady ◽  
Robert E. Lieberson
Keyword(s):  
Elderly Patient ◽  
Spinal Stenosis ◽  
Signs And Symptoms ◽  
The Elderly ◽  
Long Term Results ◽  
Neurogenic Claudication ◽  
Stabilization Procedure ◽  
Lumbar Spinal ◽  
Spine Fixation

Abstract We present a series of 25 elderly patients who exhibited signs and symptoms of neurogenic claudication and who were found to have one or two levels of spinal stenosis. At the time of decompressive surgery, excessive movement was found at the stenotic levels, so a simple stabilization procedure was performed using Knodt rods and a facet fusion. The expectation was that spine fixation would decrease the amount of postoperative back pain, which can be a result of continued abnormal mobility. All of the patients have been followed for 2 or more years. This elderly group of individuals tolerated surgery well, and long-term results were good.

scholarly journals Long-term Results After Surgical or Nonsurgical Treatment in Patients With Degenerative Lumbar Spinal Stenosis

Spine ◽  
2020 ◽  
Vol 45 (15) ◽  
pp. 1030-1038
Author(s):  
Jakob M. Burgstaller ◽  
Johann Steurer ◽  
Isaac Gravestock ◽  
Florian Brunner ◽  
Tamás F. Fekete ◽  
...  
Keyword(s):  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Nonsurgical Treatment ◽  
Long Term Results ◽  
Degenerative Lumbar Spinal Stenosis ◽  
Lumbar Spinal

scholarly journals Long-term results of surgery for lumbar spinal stenosis: a randomised controlled trial

2011 ◽  
Vol 20 (7) ◽  
pp. 1174-1181 ◽  
Author(s):  
Pär Slätis ◽  
Antti Malmivaara ◽  
Markku Heliövaara ◽  
Päivi Sainio ◽  
Arto Herno ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Controlled Trial ◽  
Long Term Results ◽  
Randomised Controlled ◽  
Lumbar Spinal ◽  
Results Of Surgery

Microsurgical unilateral laminotomy for decompression of lumbar spinal stenosis: long-term results and predictive factors

2016 ◽  
Vol 158 (6) ◽  
pp. 1103-1113 ◽  
Author(s):  
Karsten Schöller ◽  
Thomas Steingrüber ◽  
Marco Stein ◽  
Nina Vogt ◽  
Tilman Müller ◽  
...  
Keyword(s):  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Predictive Factors ◽  
Long Term Results ◽  
Lumbar Spinal

Lumbar Neurogenic Claudication

2018 ◽  
Author(s):  
Raj J. Gala ◽  
James Yue
Keyword(s):  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
The Elderly ◽  
Clinical Syndrome ◽  
Neurogenic Claudication ◽  
Epidural Steroid Injections ◽  
Magnetic Resonance Imaging Mri ◽  
Asymptomatic Individuals ◽  
Lumbar Spinal ◽  
Epidural Steroid

Lumbar neurogenic claudication, sometimes referred to as pseudoclaudication, is the clinical syndrome of back pain radiating down one or both legs during ambulation. Classically, the symptoms abate with forward flexion of the lumbar spine and worsen with extension. The condition arises from lumbar spinal stenosis, which is common in the elderly population. Many asymptomatic individuals have lumbar spinal stenosis seen on magnetic resonance imaging (MRI), so this syndrome is a clinical diagnosis. The majority of patients have favorable responses with conservative treatment, which includes physical therapy, bracing, medications, and epidural steroid injections. Patients who do not improve may go on to have surgery. Spinal stenosis has become one of the most common reasons to undergo lumbar spinal surgery in patients older than 65 years of age.

Long-term results for total lumbar facet joint replacement in the management of lumbar degenerative spondylolisthesis

2020 ◽  
Vol 32 (1) ◽  
pp. 36-41 ◽  
Author(s):  
Yossi Smorgick ◽  
Yigal Mirovsky ◽  
Yizhar Floman ◽  
Nahshon Rand ◽  
Michael Millgram ◽  
...  
Keyword(s):  
Spinal Stenosis ◽  
Facet Joint ◽  
Degenerative Spondylolisthesis ◽  
Leg Pain ◽  
Long Term Results ◽  
Neurogenic Claudication ◽  
Prospective Clinical Study ◽  
Vas Score ◽  
The Mean

OBJECTIVEThe authors evaluated the long-term clinical outcome of a total posterior arthroplasty system in the surgical treatment of lumbar spinal stenosis with degenerative spondylolisthesis.METHODSBetween June 2006 and July 2007, 10 patients with neurogenic claudication due to spinal stenosis and single-level degenerative spondylolisthesis were enrolled in a nonrandomized prospective clinical study. The patients were evaluated with radiographs and MRI scans, the visual analog scale (VAS) for back and leg pain, the Oswestry Disability Index (ODI), and the SF-36 health survey preoperatively and at 6 weeks, 3 months, 6 months, 1 year, 2 years, 3 years, 7 years, and 11 years postoperatively.RESULTSThe mean VAS score for leg pain dropped from 83.5 before surgery to 13 at 6 weeks and 17 at 11 years after surgery. The mean VAS score for back pain dropped from 56.2 preoperatively to 12.5 at 6 weeks and 14 at 11 years after surgery. The mean ODI score decreased from 49.1 preoperatively to 13.5 at 6 weeks and 16 at 11 years after surgery. MRI at 11 years demonstrated stenosis adjacent to the stabilized segment in one patient. This patient was not symptomatic. The authors did not find evidence of progression of the spondylolisthesis in any of the cases. In one patient, conversion to posterolateral fusion was performed due to an early device malfunction.CONCLUSIONSThe results of this 11-year follow-up study demonstrate that, in patients with spinal stenosis and degenerative spondylolisthesis, decompression and posterior arthroplasty maintain clinical improvement and radiological stability.

Interspinous process device versus conventional decompression for lumbar spinal stenosis: 5-year results of a randomized controlled trial

2021 ◽  
pp. 1-9
Keyword(s):  
Back Pain ◽  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Reoperation Rate ◽  
Decompressive Surgery ◽  
Long Term Results ◽  
Long Term Follow Up ◽  
Lumbar Spinal

OBJECTIVE Interspinous process distraction devices (IPDs) can be implanted to treat patients with intermittent neurogenic claudication (INC) due to lumbar spinal stenosis. Short-term results provided evidence that the outcomes of IPD implantation were comparable to those of decompressive surgery, although the reoperation rate was higher in patients who received an IPD. This study focuses on the long-term results. METHODS Patients with INC and spinal stenosis at 1 or 2 levels randomly underwent either decompression or IPD implantation. Patients were blinded to the allocated treatment. The primary outcome was the Zurich Claudication Questionnaire (ZCQ) score at 5-year follow-up. Repeated measurement analysis was applied to compare outcomes over time. RESULTS In total, 159 patients were included and randomly underwent treatment: 80 patients were randomly assigned to undergo IPD implantation, and 79 underwent spinal bony decompression. At 5 years, the success rates in terms of ZCQ score were similar (68% of patients who underwent IPD implantation had a successful recovery vs 56% of those who underwent bony decompression, p = 0.422). The reoperation rate at 2 years after surgery was substantial in the IPD group (29%), but no reoperations were performed thereafter. Long-term visual analog scale score for back pain was lower in the IPD group than the bony decompression group (p = 0.02). CONCLUSIONS IPD implantation is a more expensive alternative to decompressive surgery for INC but has comparable functional outcome during follow-up. The risk of reoperation due to absence of recovery is substantial in the first 2 years after IPD implantation, but if surgery is successful this positive effect remains throughout long-term follow-up. The IPD group had less back pain during long-term follow-up, but the clinical relevance of this finding is debatable.

Long-Term Results of Surgical Treatment of Lumbar Spinal Stenosis

Spine ◽  
1993 ◽  
Vol 18 (11) ◽  
pp. 1471-1474 ◽  
Author(s):  
Arto Herno ◽  
Olavi Airaksinen ◽  
Tapani Saari
Keyword(s):  
Surgical Treatment ◽  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Long Term Results ◽  
Lumbar Spinal
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