scholarly journals Surgical treatment of multilevel lumbar vertebral canal stenosis using dynamic stabilization. Multicenter study

2017 ◽  
Vol 24 (4) ◽  
pp. 11-17
Author(s):  
A. O Gushcha ◽  
S. V Kolesov ◽  
Ekaterina N. Poltorako ◽  
D. A Kolbovskiy ◽  
A. I Kaz’min
Keyword(s):  
Surgical Treatment ◽  
Multicenter Study ◽  
Spinal Canal ◽  
Adjacent Segment ◽  
Spinal Motion ◽  
Vertebral Canal ◽  
Transpedicular Fixation ◽  
Canal Stenosis ◽  
Sf 36 ◽  
Spine Pathology

Purpose: to compare the results of surgical treatment of patients with multilevel lumbar vertebral canal stenosis. Patients and methods. Prospective randomized multicenter study included 71 patients aged 41 - 79 years. In the 1st group of patients (n=38) a standard wide decompression of the spinal canal, transpedicular fixation of one clinically and roentgenologically significant spinal motion segment using rigid stabilization and interbody fusion was performed. In the 2nd group (n=33) microdecompression of the spinal canal, transpedicular fixation of one clinically and roentgenologically significant segment using the rods of nitinol transpedicular device. The results were assessed by the pain VAS, ODI and SF-36 questionnaires, roentgenologic, CT and MRI data. Results. Mean follow up made up 1.5 years, the maximum one - 3.0 years. Significant pain relief and im- provement in the quality of life as compared with the preoperative level was reported for both groups. No sig- nificant difference between the groups was observed. Functional roentgenograms showed within 5° (4.2 - 6.5°) preservation of motion in the stabilized segment only in patients from the 2nd group. Adjacent segment pathology in 12 months after operation was diagnosed only in 1 patient from the 1st group. Conclusion. Preliminary results allow considering the dynamic transpedicular fixation using nitinol rods as an effective surgical technique for the treatment of degenerative lumbar spine pathology.

scholarly journals Comparison of Nitinol and Titanium Nails Effectiveness for Lumbosacral Spine Fixation in Surgical Treatment of Degenerative Spine Diseases

2019 ◽  
Vol 25 (2) ◽  
pp. 59-70
Author(s):  
S. V. Kolesov ◽  
A. I. Kazmin ◽  
V. V. Shvets ◽  
A. O. Gushcha ◽  
E. N. Poltorako ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Spinal Canal ◽  
Spinal Canal Stenosis ◽  
Lower Limbs ◽  
Lumbosacral Spine ◽  
Adjacent Segment ◽  
Rigid Fixation ◽  
Degenerative Spine ◽  
Canal Stenosis ◽  
Spine Diseases

Relevance. Surgical decompression and decompression with stabilization are highly effective for treatment of spinal canal stenosis at the level of lumbar spine. However, complications developing after application of rigid fixation systems resulted in active introduction of dynamic implants into clinical practice.Purpose of the study — to compare effectiveness of nitinol and titanium nails for lumbosacral fixation in surgical treatment of degenerative spine diseases.Materials and methods. 220 patients who underwent surgeries in 4 hospitals were randomized into two groups, each consisting of 110 patients (1:1 ratio): a group of patients who underwent stabilization of the vertebral motor segments with rods of nitinol with the required volume of decompression at the operation level and a group of patients who underwent stabilization of the vertebral motor segments with standard rods of titanium with the required volume of decompression at the intervention level. Patients suffered clinically significant spinal canal stenosis in one or two adjacent segments: from L3 to S1. Outcomes were evaluated during three years postoperatively by VAS scale for spine and lower limbs, and by ODI and SF-36 scales.Results. All scales demonstrated better values in both groups of patients, namely, significant decrease of pain syndrome and improvement in mental and physical health. X-ray examination of all patients during the study period demonstrated restoration of lumbar lordosis. Group of patients with dynamic nails featured less complications rate related to metal implants including adjacent segment disease.Conclusion. Transpedicular fixation of lumbosacral spine by nitinol nails is an effective technique allowing to preserve motion along with stable fixation.

scholarly journals Stand-Alone Posterior Expandable Cage Technique for Adjacent Segment Degeneration with Lumbar Spinal Canal Stenosis: A Retrospective Case Series

Medicina ◽  
2021 ◽  
Vol 57 (3) ◽  
pp. 237
Author(s):  
Woo-Jin Choi ◽  
Seung-Kook Kim ◽  
Manhal Alaraj ◽  
Hyeun-Sung Kim ◽  
Su-Chan Lee
Keyword(s):  
Sagittal Balance ◽  
Spinal Canal ◽  
Interbody Fusion ◽  
Adjacent Segment Degeneration ◽  
Spinal Canal Stenosis ◽  
Adjacent Segment ◽  
Lumbar Spinal Canal Stenosis ◽  
Canal Stenosis ◽  
Lumbar Spinal ◽  
Expandable Cages

Background and Objectives: Symptomatic adjacent segment degeneration (ASD) with lumbar spinal canal stenosis (LSCS) is a common complication after spinal intervention, particularly interbody fusion. Stand-alone posterior expandable cages enable interbody fusion with preservation of the previous operation site, and screw-related complications are avoided. Thus, the aim of this study was to investigate the clinicoradiologic outcomes of stand-alone posterior expandable cages for ASD with LSCS. Materials and Methods: Patients with persistent neurologic symptoms and radiologically confirmed ASD with LSCS were evaluated between January 2011 and December 2016. The five-year follow-up data were used to evaluate the long-term outcomes. The radiologic parameters for sagittal balance, pain control (visual analogue scale), disability (Oswestry Disability Index), and early (peri-operative) and late (implant) complications were evaluated. Results: The data of 19 patients with stand-alone posterior expandable cages were evaluated. Local factors, such as intervertebral and foraminal heights, were significantly corrected (p < 0.01 and p < 0.01, respectively), and revision was not reported. The pain level (p < 0.01) and disability rate (p < 0.01) significantly improved, and the early complication rate was low (n = 2, 10.52%). However, lumbar lordosis (p = 0.62) and sagittal balance (p = 0.80) did not significantly improve. Furthermore, the rates of subsidence (n = 4, 21.05%) and retropulsion (n = 3, 15.79%) were high. Conclusions: A stand-alone expandable cage technique should only be considered for older adults and patients with previous extensive fusion. Although this technique is less invasive, improves the local radiologic factors, and yields favorable clinical outcomes with low revision rates, it does not improve the sagittal balance. For more widespread application, the strength of the cage material and high subsidence rates should be improved.

Results of differentiated surgical treatment of elderly and senile patients with lateral lumbar spinal canal stenosis

2017 ◽  
Vol 14 (4) ◽  
pp. 76-84
Author(s):  
Vladimir S. Klimov ◽  
Roman V. Khalepa ◽  
Ivan I. Vasilenko ◽  
Evgeny V. Konev ◽  
Evgenia V. Amelina
Keyword(s):  
Surgical Treatment ◽  
Spinal Canal ◽  
Spinal Canal Stenosis ◽  
Lumbar Spinal Canal Stenosis ◽  
Canal Stenosis ◽  
Lumbar Spinal Canal ◽  
Lumbar Spinal

Achondroplasia and cervical laminoplasty

2009 ◽  
Vol 11 (4) ◽  
pp. 417-420 ◽  
Author(s):  
June Yoshii ◽  
Vincent C. Traynelis
Keyword(s):  
Surgical Treatment ◽  
Cervical Myelopathy ◽  
Spinal Canal ◽  
Spinal Canal Stenosis ◽  
Adult Woman ◽  
Segmental Motion ◽  
Cervical Laminoplasty ◽  
Canal Stenosis

Achondroplasia is associated with short pedicles that predispose individuals with this trait to develop symptomatic spinal canal stenosis. Laminoplasty is an excellent means of treating cervical myelopathy due to stenosis in selected individuals. Laminoplasty preserves segmental motion and stability, both of which are of benefit to all individuals. The authors report the successful surgical treatment of an achondroplastic adult woman with laminoplasty. This procedure alleviated her symptoms, and she was doing well at 2-year follow-up.

scholarly journals CURRENT STATE OF CT/MRI SPINAL CANAL STENOSIS DIAGNOSIS AT THE LUMBOSACRAL LEVEL (REVIEW)

2020 ◽  
Vol 44 (1) ◽  
pp. 88-93
Author(s):  
A. S. Sementsov ◽  
V. V. Ponomarenko
Keyword(s):  
Spinal Cord ◽  
Surgical Treatment ◽  
Spinal Stenosis ◽  
Spinal Canal ◽  
Spinal Canal Stenosis ◽  
Canal Stenosis ◽  
Current State

Abstract Issues of epidemiology, classification and radiological signs of the spinal stenosis in this review are present. Modern European criteria for spinal stenosis and radicular openings can improve the diagnosis of the condition of the spinal cord and roots; clarify the criteria for indications for surgical treatment. Keywords: spinal canal stenosis, СТ/МРI, diagnosis.

scholarly journals Surgical Treatment of Stenosis of Spinal Canal and Dural Sac at the Craniovertebral Junction

2019 ◽  
Vol 3 (6) ◽  
pp. 69-76
Author(s):  
V. E. Potapov ◽  
Z. V. Koshkareva ◽  
V. A. Sorokovikov ◽  
S. N. Larionov ◽  
O. V. Sklyarenko ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Surgical Treatment ◽  
Spinal Canal ◽  
Intraoperative Complications ◽  
Odontoid Process ◽  
External Fixators ◽  
Preoperative Period ◽  
Vertebral Canal ◽  
Halo Traction ◽  
Halo Device

The paper presents the results of surgical treatment of 12 patients with stenosing processes of the vertebral canal at the craniovertebral transition due to chronic, unstable type 2 injuries of the C odontoid process (classification of fractures of odontoid process proposed in 1974 by Anderson and D’Alonzo). Patient examination included clinical-neurologic examination, review spondylograms of the cervical spine in 2 projections, MSCT, MRI. All patients were admitted to the clinic with external fixators (cervical support collar or Philadelphia collar). In the preoperative period, all patients were divided into 2 groups according to indications and contraindications for the application of the HALO-device. The first group consisted of 7 people, with cervical spine still fixed with the cervical support collar or Philadelphia collar, and the second group consisted of 5 patients with CII fracture fixed and corrected in the preoperative period by the HALO-device. All patients underwent surgical intervention – posterior approach decompression of the spinal canal and dural sack in the craniovertebral passage by CI laminectomy, partial resection of the posterior margin of the occipital aperture followed by the implementation of atlanto-axial occipitospondylodesis (a clamp with shape-memory effect for posterior occipitospondylodesis, OOO “MITS SPF”, Novokuznetsk, Russia). A comparative analysis of the results of surgical treatment of posttraumatic stenoses of the vertebral canal with and without the use of the HALO-traction device was performed. The results was better in the second group, which makes it possible to consider the second variant of surgical treatment more pathogenetically justified. Thus, HALO-traction restors anatomo-topographic relationships in the craniovertebral zone creating hard external fixation, helping to avoid intraoperative complications.

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