LONG-TERM RESULTS OF MICROSURGICAL TREATMENT OF LUMBAR SPINAL STENOSIS BY UNILATERAL LAMINOTOMY FOR BILATERAL DECOMPRESSION

Abstract OBJECTIVE Laminectomy and bilateral laminotomy are the standard procedures for decompression of lumbar spinal stenosis (LSS). With the aim of less invasiveness and better preservation of spinal stability, the technique of unilateral laminotomy for bilateral decompression (ULBD) was developed. However, limited follow-up data exist to determine the efficiency and outcome of ULBD. Therefore, the authors present their 10-year experience with ULBD and postoperative long-term results. METHODS One hundred thirty-three consecutive patients (73 men and 60 women; mean age, 63 yr) meeting clinical and radiographic criteria for LSS who underwent first-time ULBD between 1994 and 1999 entered the study. The study parameters were set to ensure a follow-up period of at least 4 years. All patients were available for short-term follow-up re-evaluation within 3 months, and 102 (77%) of the 133 patients were available for long-term examination after a mean duration of 5.6 years. The scale of Finneson and Cooper was used for evaluation of the clinical results. RESULTS One hundred thirty patients (97.7%) improved immediately after surgery. Ninety-four (92.2%) of the 102 patients available for long-term follow-up examination remained improved, and 85.3% had an excellent-to-fair operative result. The incidence of complications was 9.8%. Resurgery for complication was necessary in three patients, for restenosis in seven patients, and for spinal instability in two patients, accounting for a reoperation rate of 11.8%. CONCLUSION ULBD allows achievement of good and long-lasting operative results in patients with LSS. Postoperative deterioration, recurrences, and spinal instability are infrequent. For the authors, ULBD is the preferred technique to treat symptomatic LSS.

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

Journal of Neurosurgery Spine ◽

10.3171/2021.8.spine21419 ◽

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.

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Improvement of Back and Leg Pain after Lumbar Spinal Decompression without Fusion

Journal of Neurological Surgery Part A Central European Neurosurgery ◽

10.1055/s-0038-1669473 ◽

2018 ◽

Vol 80 (02) ◽

pp. 081-087

Author(s):

Nicola Bongartz ◽

Christian Blume ◽

Hans Clusmann ◽

Christian Müller ◽

Matthias Geiger

Keyword(s):

Back Pain ◽

Spinal Stenosis ◽

Lumbar Spinal Stenosis ◽

Leg Pain ◽

Short Term ◽

Clear Trend ◽

Long Term Follow Up ◽

Lumbar Spinal

Background To evaluate whether decompression in lumbar spinal stenosis without fusion leads to sufficient improvement of back pain and leg pain and whether re-decompression alone is sufficient for recurrent lumbar spinal stenosis for patients without signs of instability. Material and Methods A successive series of 102 patients with lumbar spinal stenosis (with and without previous lumbar surgery) were treated with decompression alone during a 3-year period. Data on pre- and postoperative back pain and leg pain (numerical rating scale [NRS] scale) were retrospectively collected from questionnaires with a return rate of 65% (n = 66). The complete cohort as well as patients with first-time surgery and re-decompression were analyzed separately. Patients were dichotomized to short-term follow-up (< 100 weeks) and long-term follow-up (> 100 weeks) postsurgery. Results Overall, both back pain (NRS 4.59 postoperative versus 7.89 preoperative; p < 0.0001) and leg pain (NRS 4.09 versus 6.75; p < 0.0001) improved postoperatively. The short-term follow-up subgroup (50%, n = 33) showed a significant reduction in back pain (NRS 4.0 versus 6.88; p < 0.0001) and leg pain (NRS 2.49 versus 6.91: p < 0.0001). Similar results could be observed for the long-term follow-up subgroup (50%, n = 33) with significantly less back pain (NRS 3.94 versus 7.0; p < 0.0001) and leg pain (visual analog scale 3.14 versus 5.39; p < 0.002) postoperatively. Patients with previous decompression surgery benefit significantly regarding back pain (NRS 4.82 versus 7.65; p < 0.0024), especially in the long-term follow-up subgroup (NRS 4.75 versus 7.67; p < 0.0148). There was also a clear trend in favor of leg pain in patients with previous surgery; however, it was not significant. Conclusions Decompression of lumbar spinal stenosis without fusion led to a significant and similar reduction of back pain and leg pain in a short-term and a long-term follow-up group. Patients without previous surgery benefited significantly better, whereas patients with previous decompression benefited regarding back pain, especially for long-term follow-up with a clear trend in favor of leg pain.

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Long term follow up in lumbar spinal stenosis

Spinal Cord ◽

10.1038/sj.sc.3100567 ◽

1998 ◽

Vol 36 (3) ◽

pp. 200-204 ◽

Cited By ~ 22

Author(s):

Martin Scholz ◽

Raimund Firsching ◽

W R Lanksch

Keyword(s):

Spinal Stenosis ◽

Lumbar Spinal Stenosis ◽

Long Term Follow Up ◽

Lumbar Spinal

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Coflex interspinous process dynamic stabilization for lumbar spinal stenosis: Long-term follow-up

Journal of Clinical Neuroscience ◽

10.1016/j.jocn.2020.09.040 ◽

2020 ◽

Vol 81 ◽

pp. 462-468

Author(s):

Ming-Rui Du ◽

Fei-Long Wei ◽

Kai-Long Zhu ◽

Ruo-Min Song ◽

Yu Huan ◽

...

Keyword(s):

Spinal Stenosis ◽

Lumbar Spinal Stenosis ◽

Dynamic Stabilization ◽

Process Dynamic ◽

Long Term Follow Up ◽

Lumbar Spinal

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The Durability of Minimally Invasive Lumbar Decompression ( mild ® ) Procedure in Patients with Symptomatic Lumbar Spinal Stenosis: Long Term Follow‐Up

Pain Practice ◽

10.1111/papr.13020 ◽

2021 ◽

Author(s):

Nagy Mekhail ◽

Shrif Costandi ◽

George Nageeb ◽

Catherine Ekladios ◽

Ogena Saied

Keyword(s):

Minimally Invasive ◽

Spinal Stenosis ◽

Lumbar Spinal Stenosis ◽

Lumbar Decompression ◽

Long Term Follow Up ◽

Lumbar Spinal

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Clinical Outcomes in Neurogenic Claudication Using a Multimodal Program for Lumbar Spinal Stenosis: A Study of 49 Patients With Prospective Long-term Follow-up

Journal of Manipulative and Physiological Therapeutics ◽

10.1016/j.jmpt.2018.11.004 ◽

2019 ◽

Vol 42 (3) ◽

pp. 203-209

Author(s):

Ngai W. Chow ◽

Danielle Southerst ◽

Jessica J. Wong ◽

Deborah Kopansky-Giles ◽

Carlo Ammendolia

Keyword(s):

Clinical Outcomes ◽

Spinal Stenosis ◽

Lumbar Spinal Stenosis ◽

Neurogenic Claudication ◽

Long Term Follow Up ◽

Lumbar Spinal

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A long-term (4- to 12-year) follow-up study of surgical treatment of lumbar spinal stenosis

European Spine Journal ◽

10.1007/s005860000161 ◽

2000 ◽

Vol 9 (6) ◽

pp. 563-570 ◽

Cited By ~ 43

Author(s):

M. Cornefjord ◽

G. Byröd ◽

H. Brisby ◽

B. Rydevik

Keyword(s):

Surgical Treatment ◽

Spinal Stenosis ◽

Lumbar Spinal Stenosis ◽

Follow Up Study ◽

Lumbar Spinal

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RETROSPECTIVE EVALUATION OF SUCCESS OF IMPLANT SUPPORTED PROSTHESIS: EARLY RESULTS

International Journal of Research -GRANTHAALAYAH ◽

10.29121/granthaalayah.v7.i12.2019.311 ◽

2020 ◽

Vol 7 (12) ◽

pp. 189-198

Author(s):

Zeynep Başağaoğlu Demirekin ◽

Yavuz Findik ◽

S. Süha Turkaslan ◽

Timuçin Baykul ◽

Merve Erken

Keyword(s):

Treatment Options ◽

Clinical Results ◽

Long Term Results ◽

Retrospective Evaluation ◽

Early Results ◽

Single Crown ◽

Long Term Follow Up ◽

Implant Therapy

Introduction: The interpretation of clinical results of dental implant supported prosthesis treatment is very crucial to be able to make a comparison between different implant systems and treatment options and furthermore to benefit the experiences of the other clinicians. However, the clinical outcomes of these studies should be reported in an objective way and be independent from the system used and also be prepared in accordance with certain criteria and standards that have been accepted scientifically world-wide for being reliable and describing long-term results. Aim: Three-hundred and eighty-two consecutive NTA implants were performed on ninety-nine patients. The implants used in 2016 and the constructed restorations were retrospectively analyzed. In addition, the effect of the experience of clinician was evaluated related with the success of the implant therapy. Materials and Method: This retrospective study was conducted in the Department of Prosthodontics Süleyman Demirel University. Three-hundred and eighty-two consecutive NTA implants were performed on ninety-nine patients. The implants used in 2016 and the constructed restorations were retrospectively analyzed. Results: The implants were followed for at least 2 years. In total, 239 implants were inserted. It was found in 143 mandibles. Prosthetic restorations were determined to be partial prosthetics (219), single crown (81) and overdenture prosthetics (64). During the evaluation period, 6 implants failed before prosthetic treatment, ten decementations, six retentive screw loosening and five porcelain chipping were detected. Discussion and Conclusions: The early results of our study are consistent with the results of other studies. However, long-term follow-up is required for more accurate assessments.

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