scholarly journals PRELIMINARY RESULTS OF VERTEBRAL CANAL DECOMPRESSION BY SPINOUS PROCESS SPLITTING

2019 ◽  
Vol 18 (3) ◽  
pp. 231-235
Author(s):  
THIAGO DANTAS MATOS ◽  
YONY OSORIO GARCIA ◽  
HERTON RODRIGO TAVARES COSTA ◽  
HELTON LUIZ APARECIDO DEFINO
Keyword(s):  
Surgical Treatment ◽  
Spinous Process ◽  
Lower Limbs ◽  
Radiographic Evaluation ◽  
Splitting Technique ◽  
Lumbar Canal Stenosis ◽  
Preliminary Results ◽  
Canal Stenosis ◽  
Lower Limb Pain ◽  
The Mean

ABSTRACT Objective Considering that the technique of spinous process splitting has been advocated as a less invasive treatment of lumbar stenosis, the objective of this study was to evaluate the preliminary results of this technique in the surgical treatment of lumbar canal stenosis. Methods Twenty patients with lumbar spinal canal stenosis who underwent surgical treatment for lumbar canal decompression with the spinous process splitting technique were assessed in the preoperative period and on postoperative days 1, 7 and 30 for VAS for lower back and lower limbs pain and radiographic evaluation of the operated segment. Results The mean visual analogue scale score for lumbar pain in the preoperative assessment was 4.2 ± 3.37 and 0.85 ± 0.88, 1.05 ± 1.19 and 1.15 ± 1.04 after 1, 7 and 30 postoperative days, respectively. The mean VAS score for lower limb pain was 8 ± 1.72 preoperatively, and 0.7 ± 1.13, 0.85 ± 1.04, and 1.05 ± 1 after 1, 7, and 30 postoperative days, respectively. There were no radiographic signs of instability of the vertebral segment operated in the radiographic evaluation. Conclusions Decompression of the lumbar canal through the spinous process splitting technique in patients with lumbar canal stenosis had good immediate and short-term results in relation to low back and lower limbs pain. Level of evidence IV; Therapeutic Study.

Lumbar spinous process-splitting technique for ligamentum flavum cyst removal: the first use in Europe.

2021 ◽  
Author(s):  
Santino Ottavio Tomasi ◽  
Giuseppe Emmanuele Emmanuele Umana ◽  
Gianluca Scalia ◽  
Giuseppe Raudino ◽  
Vlado Stevanovic ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Ligamentum Flavum ◽  
Spinous Process ◽  
Case Series ◽  
Invasive Technique ◽  
Paraspinal Muscles ◽  
Splitting Technique ◽  
Lumbar Canal Stenosis ◽  
Canal Stenosis ◽  
Lumbar Spinous Process

Background Laminotomy for lumbar stenosis is a well-defined procedure and represents a routine in every neurosurgical department. It is a common experience that the mono- or bilateral paraspinal muscles detachment together with supra and interspinous ligaments injury can lead to postoperative pain. In literature has been reported the application at the level of the lumbar spine of a minimally invasive technique defined as lumbar spinous process-splitting technique (LSPST). Methods In the current study, we present a case series of 12 patients that underwent LSPSL from September 2019 to April 2020. Two patient suffering from ligamentum flavum cyst, 8 patients with single level lumbar canal stenosis (LCS) and two patients with two-level LCS. The approach was mini-open, with reduced soft tissue dissection and without paraspinal muscles injury. Moreover, a novel morphological classification of postoperative muscle atrophy is proposed as well as a volumetric analysis of the decompression achieved. Conclusion At our knowledge, this is the first description of this surgical technique and the first LSPSL case series in Europe. Furthermore, cases of ligamentum flavum cyst removal using this safe and effective technique are not yet reported. Abbreviations Lumbar canal stenosis (LCS), lumbar spinous process-splitting technique (LSPST), minimally invasive spine surgery (MISS)

Lumbar spinous process—splitting laminectomy for lumbar canal stenosis

2005 ◽  
Vol 3 (5) ◽  
pp. 405-408 ◽  
Author(s):  
Kota Watanabe ◽  
Toshihiko Hosoya ◽  
Tateru Shiraishi ◽  
Morio Matsumoto ◽  
Kazuhiro Chiba ◽  
...  
Keyword(s):  
Spinous Process ◽  
Paraspinal Muscles ◽  
Paravertebral Muscle ◽  
Content Type ◽  
Lumbar Canal Stenosis ◽  
Canal Stenosis ◽  
The Mean ◽  
Supporting Structures ◽  
Lumbar Spinous Process ◽  
Fine Print

✓ In conventional laminectomy for lumbar canal stenosis (LCS), intraoperative damage of posterior supporting structures can lead to irreversible atrophy of paraspinal muscles. In 2001, the authors developed a new procedure for lumbar laminectomy, the lumbar spinous process—splitting laminectomy (LSPSL). In this new procedure, the spinous process is split longitudinally in the middle and then divided at its base from the posterior arch, leaving the bilateral paraspinal muscles attached to the lateral aspects. Ample working space for laminectomy is obtained by retracting the split spinous process laterally together with its attached paraspinal muscles. After successfully decompressing nerve tissues, each half of the split spinous process is reapproximated using a strong suture. Thus, the supra- and interspinous ligaments are preserved, as is the spinous process, and damage to the paraspinal muscles is minimal. Eighteen patients with LCS underwent surgery in which this new technique was used. Twenty patients in whom conventional laminectomy was undertaken were chosen as controls. At 2 years, the clinical outcomes (as determined using the Japanese Orthopaedic Association [JOA] scores and recovery rate) and the rate of measured magnetic resonance imaging—documented paravertebral muscle atrophy were evaluated and compared between the two groups. The mean JOA score recovery rates were 67.6 and 59.2%, respectively, for patients treated with LSPSL and conventional laminectomy; the mean rates of paravertebral muscle atrophy were 5.3 and 23.9%, respectively (p = 0.0005). Preservation of posterior supporting structures and satisfactory recovery rate after 2 years indicated that this technique can be a useful alternative to conventional decompression surgery for lumbar canal stenosis.

scholarly journals Post-operative Results of Surgical Treatment for Lumbar Canal Stenosis. With Fusion VS Without Fusion.

1998 ◽  
Vol 47 (1) ◽  
pp. 60-63
Author(s):  
Toshiaki Takahashi ◽  
Kenji Ohtsuki ◽  
Tosihiko Takita ◽  
Masatoshi Nakashima ◽  
Tatsuhiro Hashimoto ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Operative Results ◽  
Lumbar Canal Stenosis ◽  
Canal Stenosis

scholarly journals Surgical treatment of lumbar canal stenosis.

1988 ◽  
Vol 36 (4) ◽  
pp. 1236-1238
Author(s):  
Hirotsugu Oda ◽  
Shinya Kawai ◽  
Kenji Kido ◽  
Kenji Igarashi ◽  
Kohichirou Ihara ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Lumbar Canal Stenosis ◽  
Canal Stenosis

scholarly journals Outcome of Surgical Treatment for Lumbar Canal Stenosis in Patients Aged 80 or More.

2001 ◽  
Vol 50 (1) ◽  
pp. 46-48
Author(s):  
Fumihiro Miyaguchi ◽  
Yoshihisa Kawauchi ◽  
Koji Sameshima
Keyword(s):  
Surgical Treatment ◽  
Lumbar Canal Stenosis ◽  
Canal Stenosis

scholarly journals Surgical Treatment of Severe Idiopathic Flexible Flatfoot by Evans–Mosca Technique in Adolescent Patients: A Long-Term Follow-Up Study

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Vincenzo De Luna ◽  
Fernando De Maio ◽  
Alessandro Caterini ◽  
Martina Marsiolo ◽  
Lidio Petrungaro ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Weight Bearing ◽  
Radiographic Examination ◽  
Radiographic Evaluation ◽  
Foot And Ankle ◽  
Flexible Flatfoot ◽  
Adolescent Patients ◽  
The Mean

Flexible idiopathic flatfoot is very common in growing age and rarely causes pain or disability. Surgery is indicated only in severe symptomatic cases that are resistant to conservative treatment, and numerous surgical procedures have been proposed. Lateral column calcaneal lengthening as described by Evans and modified by Mosca is a widely used surgical technique for the correction of severe symptomatic flexible flatfoot. In the present study, we report the long-term clinical and radiographic results in 14 adolescent patients (mean age: 12.8 years) affected by severe symptomatic flexible flatfoot, surgically treated by Evans–Mosca procedure, for a total of 26 treated feet (12 cases bilateral and 2 unilateral). In all cases, surgery was indicated for the presence of significant symptoms resistant to nonsurgical management. Clinical evaluation was made according to the American Orthopedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Scale, the Foot and Ankle Disability Index (FADI) Score, and Yoo et al.’s criteria. Radiographic evaluation was made using anteroposterior and lateral weight-bearing radiographs of the feet to evaluate Meary’s angle and Costa–Bertani’s angle and to evaluate possible osteoarthritic changes in the midtarsal joints. At follow-up (mean: 7 years and 7 months), we observed a satisfactory result in all patients. The mean average score of the AOFAS Ankle-Hindfoot Scale improved from 60.03 points to 95.26; the mean FADI score improved from 71.41 to 97.44; and according to Yoo et al.’s criteria, the average clinical outcome score was 10.96. At radiographic examination, nonunion of the calcaneal osteotomy was never observed. Meary’s angle improved from an average preoperative value of 25° to 1.38° at follow-up; Costa–Bertani’s angle improved from an average preoperative value of 154.2° to 130.9° at follow-up. In no case, significant radiographic signs of midtarsal joint arthritis were observed. According to our results, we believe that Evans–Mosca technique is a valid option of surgical treatment for severe idiopathic flexible flatfoot and allows a satisfactory correction of the deformity with a low rate of complications.

Reduced postoperative wound pain after lumbar spinous process–splitting laminectomy for lumbar canal stenosis: a randomized controlled study

2011 ◽  
Vol 14 (1) ◽  
pp. 51-58 ◽  
Author(s):  
Kota Watanabe ◽  
Morio Matsumoto ◽  
Takeshi Ikegami ◽  
Yuji Nishiwaki ◽  
Takashi Tsuji ◽  
...  
Keyword(s):  
Muscle Atrophy ◽  
Spinous Process ◽  
Controlled Study ◽  
Postoperative Wound ◽  
Atrophy Rate ◽  
Canal Stenosis ◽  
Wound Pain ◽  
The Mean ◽  
Pain Analgesics ◽  
Lumbar Spinous Process

Object To reduce intraoperative damage to the posterior supporting structures of the lumbar spine during decompressive surgery for lumbar canal stenosis (LCS), lumbar spinous process–splitting laminectomy (LSPSL or split laminectomy) was developed. This prospective, randomized, controlled study was conducted to clarify whether the split laminectomy decreases acute postoperative wound pain compared with conventional laminectomy. Methods Forty-one patients with LCS were enrolled in this study. The patients were randomly assigned to either the LSPSL group (22 patients) or the conventional laminectomy group (19 patients). Questionnaires regarding wound pain (intensity, depth, and duration) and activities of daily living (ADL) were administered at postoperative days (PODs) 3 and 7. Additionally, the authors evaluated the pre- and postoperative serum levels of C-reactive protein and creatine phosphokinase, the amount of pain analgesics used during a 3-day postoperative period, and the muscle atrophy rate measured on 1-month postsurgical MR images. Results Data obtained in patients in the LSPSL group and in 16 patients in the conventional laminectomy group were analyzed. The mean visual analog scale for wound pain on POD 7 was significantly lower in the LSPSL group (16 ± 17 mm vs 34 ± 31 mm, respectively; p = 0.04). The mean depth-of-pain scores on POD 7 were significantly lower in the LSPSL group than in the conventional group (0.9 ± 0.6 vs 1.7 ± 0.8, respectively; p = 0.013). On POD 3, the mean serum creatine phosphokinase level was significantly lower in the LSPSL group (126 ± 93 U/L) than in the other group (207 ± 150 U/L) (p = 0.02); on POD 7, the mean serum C-reactive protein level was significantly lower in the LSPSL group (1.1 ± 0.6 mg/dl) than in the conventional laminectomy group (1.9 ± 1.5 mg/dl) (p = 0.04). The number of pain analgesics taken during the 3-day postoperative period was lower in the LSPSL group than in the conventional laminectomy group (1.7 ± 1.3 tablets vs 2.3 ± 2.4 tablets, respectively; p = 0.22). The mean muscle atrophy rate was also significantly lower in the LSPSL group (24% ± 15% vs 43% ± 22%; p = 0.004). Conclusions Lumbar spinous process–splitting laminectomy for the treatment of LCS reduced acute postoperative wound pain and prevented postoperative muscle atrophy compared with conventional laminectomy, possibly because of minimized damage to the paraspinal muscles.

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