scholarly journals Features of TLIF/PLIF in lumbar spine nerve root anomalies. The literature review and own experience

2021 ◽  
Vol 23 (3) ◽  
pp. 75-84
Author(s):  
I. V. Basankin ◽  
A. A. Giulzatyan ◽  
K. K. Takhmazyan ◽  
S. B. Malakhov ◽  
M. I. Tomina ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Pain Syndrome ◽  
Contralateral Side ◽  
Radicular Pain ◽  
Preoperative Pain ◽  
Nerve Roots ◽  
Planning Strategy ◽  
Results Of Treatment ◽  
Preoperative Stage ◽  
Iatrogenic Damage

Introduction. Anomalies of the roots of the lumbar spine are often not diagnosed at the preoperative stage and may cause technical difficulties during performing decompression‑stabilization surgeries of spine.Purpose of the study. To study the clinical features of patients with anomalies of the lumbar roots on the background of de‑ generative diseases of the spine, to develop techniques to protect abnormal nerve roots from damage during TLIF/PLIF.Materials and methods. Performed retrospective analysis of the results of treatment of 9 patients whom were done TLIF/PLIF for degenerative‑dystrophic diseases of the lumbar spine in the period from 2018–2019 was. The distribution of changes detected in the spine was carried out according to the classification of Schizas, Meyerding and Neidre & Macnab.Results. The study group of patients was 0.63 % of all operated patients using the TLIF/PLIF technique (n = 1432). Developmental anomalies of the nerve roots were not identified during routine MRI in all patients. In six patients (66.7 %), radicular pain manifested in two dermatomes; intraoperatively, these patients had conjoint roots (Ia). Three pa‑ tients (33.3 %) had radicular pain in several (>2) dermatomes. The root tension sign (Lasegue sign) was negative in eight (88.9 %) patients. The intensity of the preoperative pain syndrome in the leg averaged 6.44 (VAS), in the back 6.11, and in the postoperative period it decreased to 0.7 and 2.1, respectively.Conclusion. Clinical preoperative markers for the presence of root anomalies can be two‑dermatomal radicular mani‑ festations in the presence of a single‑level process, as well as the absence of a Lasegue sign in severe radiculopathy. Intraoperative detection of anomalies requires a balanced approach to the choice of the method of surgical intervention from the surgeon. To prevent iatrogenic damage of anomaly roots at the stage of surgical treatment, it is necessary to change the preoperative planning strategy in favor of choosing the contralateral side for interbody fusion. In addition, root traction and interbody distraction should be minimal.

scholarly journals ANALYSIS OF THE RESULTS OF STAGING DECOMPRESSION/STABILIZATION INTERVENTIONS IN THE TREATMENT OF PATIENTS WITH TANDEM STENOSIS OF CERVICAL AND LUMBAR SPINE

2016 ◽  
Vol 1 (4) ◽  
pp. 85-90
Author(s):  
Шепелев ◽  
Valeriy Shepelev ◽  
Сороковиков ◽  
Vladimir Sorokovikov ◽  
Калинин ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Surgical Procedures ◽  
Neck Disability Index ◽  
Pain Syndrome ◽  
Analog Scale ◽  
Results Of Treatment ◽  
Tandem Stenosis ◽  
The Moment ◽  
Neck Disability ◽  
Consistent Approach

The concept of “tandem stenosis” comprises combination of degenerative stenosis in both cervical and lumbar spine. At the moment, there is no consistent approach to the surgical procedures in this group of patients, as well as the research-ers do not pay much attention in their papers to the sequence and stage-by-stage approach to the procedures and to the analysis of combined surgical procedures. The aim of the research was to analyze the results of staging decompression/stabilization interventions in the treatment of patients with tandem stenosis of cervical and lumbar spine. We performed a retrospective analysis of prospectively collected results of treatment of 46patients with combined (tandem) stenosis of cervical and lumbar spine. The patients were operated in four neurosurgical clinical units of Vladivostok, Irkutsk and Novosibirsk. We assessed clinical data: level of pain syndrome – using visual analog scale (VAS), neck disability index (NDI), Oswestry disability index (ODI), MacNab and Nurick clinical outcomes, as well as the results of plain spine radiography and neuroimaging studies (MRI, MSCT). Multicenter study of the results of staging surgical procedures with the use of specialized microsurgical instruments in the treatment of patients with tandem stenosis of cervical and lumbar spine allowed us to confirm their high clinical and radiological effectiveness.

scholarly journals Porous TiNi Implants in Surgery of Spine Degenerative Diseases

2017 ◽  
Vol 2 (1) ◽  
pp. 334
Author(s):  
A.E. Simonovich ◽  
N.G. Fomichev
Keyword(s):  
Surgical Treatment ◽  
Lumbar Spine ◽  
Pain Syndrome ◽  
Functional Results ◽  
Spiral Ct ◽  
Bone Block ◽  
Results Of Treatment ◽  
Block Formation ◽  
Osteoplastic Material ◽  
Metal Block

Objective. To evaluate the efficacy of using porous TiNi implants for interbody fusion in the treatment of lumbar spine degenerative diseases.Material and Methods. A total of 570 patients with degenerative lumbar spine disease were operated on with porous TiNi implants. Surgical treatment included stabilization and decompression and stabilization operations through posterior and anterior approaches and endoscopic transabdominal operations. Results of surgical treatment were followed-up for the period of 3 to 24 months. The change of pain syndrome was evaluated using a Visual Analogue Scale (VAS) and Oswestry Disability Index. The degree of interbody bone block formation was assessed based on X-ray and spiral CT data.Results. Functional results of treatment were evaluated at 18-24 months after surgery as good and satisfactory in 94.1% of cases, and the formation of interbody bone-metal block was noted in 94.8% of cases.Conclusion. Nikelid Titanium exhibits good osseointegration properties and can be used as osteoplastic material without additions of bone tissue, which simplifies operation, reduces its traumaticity, and provides good and satisfactory treatment results in 94.1% of cases.

scholarly journals Epidural administration of anesthetics and corticosteroids in treatment of acute radicular pain syndrome of lumbar spine in neurosurgical department

2015 ◽  
Vol 0 (1) ◽  
pp. 51-54
Author(s):  
Valeriy Olkhov ◽  
O. Buyanov ◽  
Kostyantyn Horbatyuk ◽  
O. Kudina ◽  
Leonid Ventskivskiy ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Pain Syndrome ◽  
Radicular Pain ◽  
Epidural Administration ◽  
Neurosurgical Department

scholarly journals Lumbar Microdiscectomy. Retrospective Analysis of the Results of Treatment of 54 Patients

2021 ◽  
pp. 34-41
Author(s):  
D.V. Uleshchenko ◽  
A.T. Stashkevych ◽  
L.O. Bublyk ◽  
A.V. Shevchuk
Keyword(s):  
Surgical Treatment ◽  
Retrospective Analysis ◽  
Life Quality ◽  
Pain Syndrome ◽  
Radicular Pain ◽  
Lumbar Pain ◽  
Results Of Treatment ◽  
Herniated Disk ◽  
Poor Outcomes ◽  
Surgery Department

Summary. Although the microdiscectomy techniques for surgical treatment of a herniated disk are improved, the share of poor outcomes after the lumbar pain syndrome treatment remains high. Objective: to improve the outcomes of patients with lumbar spine osteochondrosis complicated with a herniated disk. Materials and Methods. The retrospective analysis of 54 patients with a lumbar herniated disk, who underwent surgical treatment from 2019 till 2020 at the Spine Surgery Department of the SI “Institute of Traumatology and Orthopedics of NAMS of Ukraine”. The age of patients varied from 23 to 78 years (mean age – 41.1±11.7 years). Results. We assessed the outcomes using VAS, Oswestry, and Nurick scales on the first day after the surgery, one month, and six months after it. VAS of the lower back pain syndrome declined on average from 5.9±1.59 to 3.4±1.55 on the first day after the surgery, to 1.7±1.1 in a month, and to 2.5±2.1 six months after the surgical treatment. The surgery eliminates radiculopathy and reduces radicular pain according to VAS on average from 8.5±1.17 to 1.3±1.04 on the first day after the surgery, to 1.5±1.0 in a month, and to 1.4±1.6 six months after it. The quality of life according to ODI improved on average from 74.4±5.12 before the surgery to 29.7±9.6 in a month and to 9.6±9.2 six months postoperatively. As of the discharge, 55.6% of patients demonstrated their nervous system's function recovered to the stage I and 38.9% – to the stage II. The long-term follow-up has shown positive dynamics in all the patients: the complete regress of neurologic symptoms in 74.4% and improved conditions – in 25.6% of patients. Conclusions. Surgical treatment of a herniated lumbar disk with the microdiscectomy method ensures the fulfillment of the fundamental nerve rootlet decompression by fenestrotomy, disctomy, or discectomy, and excision of the hernia, including sequestrated one. The positive dynamics of the pain syndrome scores, life quality, and neurological disorders is significant (р<0.05) and substantiates the efficiency of the treatment.

Treatment radicular pain syndrome caused by pathologyin the lumbar spine in the acute period

2011 ◽  
Vol 28 ◽  
pp. 204
Author(s):  
A. Gnezdilov ◽  
O. Zagorulko ◽  
L. Medvedeva ◽  
N. Samoylova
Keyword(s):  
Lumbar Spine ◽  
Pain Syndrome ◽  
Radicular Pain ◽  
Acute Period

Lumbar periarticular cysts of arcorray joint

2020 ◽  
pp. 47-57
Author(s):  
Anton Yarikov ◽  
Maxim Shpagin ◽  
Iliya Nazmeev ◽  
Sergey Gorelov ◽  
Olga Perlmutter
Keyword(s):  
Minimally Invasive ◽  
Severe Pain ◽  
Pain Syndrome ◽  
Long Term Results ◽  
Lumbar Region ◽  
Results Of Treatment ◽  
Invasive Method ◽  
Facet Syndrome

The immediate and long-term results of treatment of 30 patients with severe pain syndrome of the lumbar region, who underwent operations on denervation of DOS, were studied. The aim of the study was to evaluate the effectiveness of minimally invasive technologies for the treatment of pain in the lumbar region (denervation of DOS), to study the near and distant results of these treatment methods. Denervation DOS is an effective minimally invasive method for the treatment of facet syndrome caused by spondylarthrosis. It allows in the early and distant postoperative periods to significantly reduce the pain syndrome and improve the quality of life of patients.

scholarly journals Gravity determines the direction of nerve roots sedimentation in the lumbar spinal canal

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Jun Yang ◽  
Zhiyun Feng ◽  
Nian Chen ◽  
Zhenhua Hong ◽  
Yongyu Zheng ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Mr Imaging ◽  
Spinal Canal ◽  
Ventral Side ◽  
Lateral Position ◽  
Dorsal Side ◽  
Mr Images ◽  
Nerve Roots ◽  
Cross Sectional ◽  
Dural Sac

Abstract Objectives To investigate the role of gravity in the sedimentation of lumbar spine nerve roots using magnetic resonance (MR) imaging of various body positions. Methods A total of 56 patients, who suffered from back pain and underwent conventional supine lumbar spine MR imaging, were selected from sanmen hospital database. All the patients were called back to our hospital to perform MR imaging in prone position or lateral position. Furthermore, the sedimentation sign (SedSign) was determined based on the suspension of the nerve roots in the dural sac on cross-sectional MR images, and 31 cases were rated as positive and another 25 cases were negative. Results The mean age of negative SedSign group was significantly younger than that of positive SedSign group (51.7 ± 8.7 vs 68.4 ± 10.5, P < 0.05). The constitutions of clinical diagnosis were significantly different between patients with a positive SedSign and those with a negative SedSign (P < 0.001). Overall, nerve roots of the vast majority of patients (48/56, 85.7%) subsided to the ventral side of the dural sac on the prone MR images, although that of 8 (14.3%) patients remain stay in the dorsal side of dural sac. Nerve roots of only one patient with negative SedSign did not settle to the ventral dural sac, while this phenomenon occurred in 7 patients in positive SedSign group (4% vs 22.6%, P < 0.001). In addition, the nerve roots of all the five patients subsided to the left side of dural sac on lateral position MR images. Conclusions The nerve roots sedimentation followed the direction of gravity. Positive SedSign may be a MR sign of lumbar pathology involved the spinal canal.

Chondroblastoma of the lumbar spine

2005 ◽  
Vol 2 (5) ◽  
pp. 596-600 ◽  
Author(s):  
Raphaël Vialle ◽  
Antoine Feydy ◽  
Ludovic Rillardon ◽  
Carla Tohme-Noun ◽  
Philippe Anract ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Local Recurrence ◽  
Osteolytic Lesion ◽  
Radicular Pain ◽  
Appendicular Skeleton ◽  
Lumbar Region ◽  
Content Type ◽  
Anterior Posterior ◽  
Fine Print

✓ Chondroblastoma is a benign cartilaginous neoplasm that generally affects the appendicular skeleton. Twenty-six cases of spinal chondroblastoma have been reported in the past 50 years, only six of which were located in the lumbar region. The authors report two cases involving this exceptional location. In both patients, low-back pain, in the absence of radicular pain, was the presenting symptom. In both cases, plain radiography and computerized tomography scanning revealed an osteolytic lesion surrounded by marginal sclerosis. Magnetic resonance imaging allowed the authors to study the tumor's local extension. Examination of a percutaneous fluoroscopy-guided biopsy sample revealed the following typical histological features of chondroblastoma: chondroid tissue, focally alternating with cellular areas, and no nuclear atypia or pleomorphism. To reduce the risk of local recurrence, vertebrectomy and anterior—posterior fusion were performed in both cases. In one case, a structural lumbar scoliosis was corrected during the posterior procedure. There was no postoperative complication. No recurrence was observed during the 3- to 6-year follow-up period. The surgery-related results were deemed successful. Although exceptional, the diagnosis of chondroblastoma is possible in lesions involving the lumbar spine. Other spinal locations are described in the literature, and frequency of recurrence is stressed. A vertebrectomy is advised to reduce the risk of local recurrence.

DISORDERS OF PERIPHERAL CIRCULATION AMID CHRONIC OSTEOCHONDROSIS OF THE LUMBAR SPINE

Vestnik ◽  
2021 ◽  
pp. 24-28
Author(s):  
Р.С. Бегимбетова ◽  
Н.О. Бейсембинова ◽  
А.К. Кадырали ◽  
Г.М. Жолдасова ◽  
А. Бауржанкызы ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Informed Consent ◽  
Clinical Symptoms ◽  
Personal Data ◽  
Pain Syndrome ◽  
Peripheral Circulation ◽  
Research Protocol ◽  
Initial Visit ◽  
Continue Research ◽  
Inhibitory Reflex

Проведен анализ состояния периферического кровообращения у 28 мужчин, больных остеохондрозом поясничного отдела позвоночника, сопровождающегося люмбалгией с клинической симптоматикой нарушения периферического кровообращения нижних конечностей. Все больные, принимавшие участие в нашем исследовании, подписали информированное согласие на участие в программе и соглашение о неразглашении личных данных и протокола исследований. Критериями для анализа являлись изменения клинической симптоматики остеохондроза поясничного отдела позвоночника, обусловленной им люмбалгии и показателей оксиметрического исследования, которые были зафиксированы при первичном обращении и через 7 суток на фоне проводимого лечения и регрессии болевого синдрома. Таким образом, полученные результаты свидетельствовали о рефлекторном нарушении периферического кровообращения за счет развития патологического спинально-вазального тормозного рефлекса, обусловленного люмбалгией, которые восстанавливаются на фоне регрессии патологической импульсации в поясничном отделе позвоночника. Целесообразно продолжить исследования в этом направлении. The state of peripheral circulation in 28 men were analyzed, patients with osteochondrosis of the lumbar spine, accompanied by lumbodynia with clinical symptoms of impaired peripheral circulation of the lower extremities was carried out. All patients who took part in our study signed an informed consent to participate in the program and a non-disclosure agreement of personal data and research protocol. The criteria for the analysis were clinical symptoms of osteochondrosis of the lumbar spine caused by lumbodynia and indicators of oximetry studies, which were recorded during the initial visit and after 7 days amid treatment and regression of pain syndrome. Thus, the results indicated a reflex disorder of the peripheral circulation due to the development of a pathological spinal-vasal inhibitory reflex caused by lumbodynia, which is restored amid regression of pathological impulses in the lumbar spine. It is advisable to continue research in this direction.

scholarly journals The Interspinous Spacer: A New Posterior Dynamic Stabilization Concept for Prevention of Adjacent Segment Disease

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Antoine Nachanakian ◽  
Antonios El Helou ◽  
Moussa Alaywan
Keyword(s):  
Lumbar Spine ◽  
Preventive Measure ◽  
Radicular Pain ◽  
Dynamic Stabilization ◽  
Adjacent Segment Disease ◽  
Neurogenic Claudication ◽  
Adjacent Segment ◽  
Disability Score ◽  
Interspinous Spacer ◽  
Posterior Dynamic Stabilization

Introduction. Posterior Dynamic stabilization using the interspinous spacer device is a known to be used as an alternative to rigid fusion in neurogenic claudication patients in the absence of macro instability. Actually, it plays an important in the management of adjacent segment disease in previously fused lumbar spine.Materials and Method. We report our experience with posterior dynamic stabilization using an interspinous spacer. 134 cases performed in our institution between September 2008 and August 2012 with different lumbar spine pathologies. The ages of our patients were between 40 and 72 years, with a mean age of 57 years. After almost 4 years of follow up in our patient and comparing their outcome to our previous serious we found that in some case the interspinous distracter has an important role not only in the treatment of adjacent segment disease but also in its prevention.Results and Discussion. Clinical improvement was noted in ISD-treated patients, with high satisfaction rate. At first, radicular pain improves with more than 3/10 reduction of the mean score on visual analog scale (VAS). In addition, disability score as well as disc height and lordotic angle showed major improvement at 3 to 6 months post operatively. And, no adjacent segment disease was reported in the patient operated with interspinous spacer.Conclusion. The interspinous spacer is safe and efficient modality to be used not only as a treatment of adjacent segment disease but also as a preventive measure in patients necessitating rigid fusion.

Sign in / Sign up

Export Citation Format

Share Document