scholarly journals CT Classification of Vacuum Phenomenon Morphology and its Utility in Predicting Lumbar Vertebral Instability

2020 ◽  
Author(s):  
Noah Kelm ◽  
Jennifer Hella ◽  
John B Westfall ◽  
Eric T Ballard ◽  
Macksood A Aftab
Keyword(s):  
Lumbar Fusion ◽  
Ct Images ◽  
Fine Tuning ◽  
X Rays ◽  
Fusion Surgery ◽  
Vacuum Phenomenon ◽  
Lumbar Fusion Surgery ◽  
Flexion Extension ◽  
Ct Classification ◽  
Anterior Subluxation

Abstract Background: Lumbar vacuum phenomenon (VP) within the intervertebral disc has been classified based on CT imaging. We compared same-patient sagittal CT images and dynamic flexion-extension x-rays to determine if there is a difference in the amount of vertebral instability present between three VP morphologies on CT.Methods: Anterior subluxation measurements on x-ray were compared with same-segment VP on CT images from the same patient when both findings were present. VP were classified as spot, island, or linear. It was determined if there was a difference in the amount of anterior subluxation between the three morphologies. Secondary analysis looked at whether there was a difference in anterior subluxation between the three groups if patients had undergone a prior lumbar fusion surgery or not. Results: There was no difference in anterior subluxation between the three groups on dynamic flexion-extension x-rays. There was also no difference between the three groups on flexion-extension x-rays when patients were separated based on if they had received or not received a previous lumbar fusion surgery. Conclusion: IVD VP morphology is not a useful indicator in determining vertebral instability pre-operatively according to CT scan. Further fine-tuning of an IVD VP CT classification is needed to help radiologists and spine surgeons know when IVD VP presence is important.

Lumbar Fusion Surgery for Patients With Back Pain and Degenerative Disc Disease: An Observational Study From the Canadian Spine Outcomes and Research Network

2021 ◽  
pp. 219256822098547
Author(s):  
Nathan Evaniew ◽  
Ganesh Swamy ◽  
W. Bradley Jacobs ◽  
Jacques Bouchard ◽  
Roger Cho ◽  
...  
Keyword(s):  
Back Pain ◽  
Degenerative Disc Disease ◽  
Short Form ◽  
Lumbar Fusion ◽  
Research Network ◽  
Disc Disease ◽  
Fusion Surgery ◽  
Degenerative Disc ◽  
Lumbar Fusion Surgery ◽  
Related Quality

Study Design: Uncontrolled retrospective observational study. Objectives: Surgery for patients with back pain and degenerative disc disease is controversial, and studies to date have yielded conflicting results. We evaluated the effects of lumbar fusion surgery for patients with this indication in the Canadian Spine Outcomes and Research Network (CSORN). Methods: We analyzed data that were prospectively collected from consecutive patients at 11 centers between 2015 and 2019. Our primary outcome was change in patient-reported back pain at 12 months of follow-up, and our secondary outcomes were satisfaction, disability, health-related quality of life, and rates of adverse events. Results: Among 84 patients, we observed a statistically significant improvement of back pain at 12 months that exceeded the threshold of Minimum Clinically Important Difference (MCID) (mean change -3.7 points, SD 2.6, p < 0.001, MCID = 1.2; 77% achieved MCID), and 81% reported being “somewhat” or “extremely” satisfied. We also observed improvements of Oswestry Disability Index (-17.3, SD 16.6), Short Form-12 Physical Component Summary (10.3, SD 9.6) and Short Form-12 Mental Component Summary (3.1, SD 8.3); all p < 0.001). The overall rate of adverse events was 19%. Conclusions: Among a highly selective group of patients undergoing lumbar fusion surgery for degenerative disc disease, most experienced a clinically significant improvement of back pain as well as significant improvements of disability and health-related quality of life, with high satisfaction at 1 year of follow-up. These findings suggest that surgery for this indication may provide some benefit, and that further research is warranted.

The validity of using activity monitors to detect step count after lumbar fusion surgery

2018 ◽  
Vol 42 (6) ◽  
pp. 863-868 ◽  
Author(s):  
Sarah J. Gilmore ◽  
Megan Davidson ◽  
Andrew J. Hahne ◽  
Jodie A. McClelland
Keyword(s):  
Lumbar Fusion ◽  
Step Count ◽  
Fusion Surgery ◽  
Activity Monitors ◽  
Lumbar Fusion Surgery

scholarly journals Effect of the duration of chronic low back pain on pain sensitivity of patients undergoing lumbar fusion surgery

Pain medicine ◽  
2021 ◽  
Vol 5 (4) ◽  
pp. 8-15
Author(s):  
Mei-ping Qian ◽  
Mei-rong Dong ◽  
Fang Kang ◽  
Juan Li
Keyword(s):  
Chronic Pain ◽  
Low Back Pain ◽  
Back Pain ◽  
Hospital Stay ◽  
Chronic Low Back Pain ◽  
Pain Sensitivity ◽  
Lumbar Fusion ◽  
Low Back ◽  
Fusion Surgery ◽  
Lumbar Fusion Surgery

Background: chronic low back pain is a serious social problem. In recent years, patients who choose lumbar fusion surgery due to chronic low back pain has been increasing. Pre-existing chronic pain has been associated with severe postoperative pain. In this study, we have sought to prospectively analyze the association between the duration of chronic low back pain and pain sensitivity after lumbar fusion surgery. Methods: 400 patients who underwent lumbar fusion surgery were divided into three groups based on the duration of chronic pain. During the first postoperative day, the maximum pain scores of each patient day and night, the pain scores at the day of discharge, the consumption of postoperative analgesics and the length of hospital stay were recorded. Results: of 400 patients recruited, 369 patients completed the experiment. There was no significant difference in gender, age, height, weight, pre-operative pain at rest, and operation time in the three groups. During the day, the pain sensitivity of the three groups were 1.71 ± 0.66, 2.40 ± 0.74, 2.90 ± 0.80. During the night, the pain sensitivity of the three groups were 3.45 ± 0.81, 4.31 ± 1.06, 4.86 ± 1.05. At the day of discharge, the pain sensitivity of three groups were 1.26 ± 0.46, 1.47 ± 0.58, 1.96 ± 0.64. There were significant differences in pain sensitivity among the three groups during the day and night on the first postoperative day and at the day of discharge (p < 0.05). The length of hospital stay (7.31 ± 1.36 days, 8.82 ± 1.48 days, 9.60 ± 1.61 days) and analgesic consumption (25.04 ± 36.56 mg, 33.52 ± 24.04 mg, 45.15 ± 24.89 mg, morphine equivalent) were also significant differences (p < 0.05). Conclusion: we found the duration of chronic low back pain before lumbar fusion surgery affects patient’ postoperative pain sensitivity, consumption of analgesic drugs and hospital stay. The longer the preoperative chronic pain lasts, the higher the postoperative VAS score is, the more analgesic drugs were consumed, and the longer hospital stay is.

Preoperative and Postoperative Factors and Laboratory Values Predicting Outcome in Patients Undergoing Lumbar Fusion Surgery

2016 ◽  
Vol 92 ◽  
pp. 323-338 ◽  
Author(s):  
Severina Leu ◽  
Maria Kamenova ◽  
Arne Mehrkens ◽  
Luigi Mariani ◽  
Stefan Schären ◽  
...  
Keyword(s):  
Lumbar Fusion ◽  
Fusion Surgery ◽  
Lumbar Fusion Surgery ◽  
Laboratory Values ◽  
Predicting Outcome

scholarly journals Leg pain and psychological variables predict outcome 2–3 years after lumbar fusion surgery

2011 ◽  
Vol 20 (10) ◽  
pp. 1626-1634 ◽  
Author(s):  
Allan D. Abbott ◽  
Raija Tyni-Lenné ◽  
Rune Hedlund
Keyword(s):  
Lumbar Fusion ◽  
Leg Pain ◽  
Psychological Variables ◽  
Fusion Surgery ◽  
Lumbar Fusion Surgery

scholarly journals Trends in Lumbar Fusion Surgery Among Octogenarians: A Nationwide Inpatient Sample Study From 2004 to 2013

2018 ◽  
Vol 8 (6) ◽  
pp. 593-599 ◽  
Author(s):  
Stephanie T. Kha ◽  
Haariss Ilyas ◽  
Joseph E. Tanenbaum ◽  
Edward C. Benzel ◽  
Michael P. Steinmetz ◽  
...  
Keyword(s):  
Nationwide Inpatient Sample ◽  
Lumbar Fusion ◽  
Fusion Surgery ◽  
Lumbar Fusion Surgery

scholarly journals Comparisons of Lumbar Muscle Performance Between Minimally-Invasive and Open Lumbar Fusion Surgery at 1-Year Follow-Up

2020 ◽  
pp. 219256822097966
Author(s):  
Meng-Ling Lu ◽  
Chih-Hsiu Cheng ◽  
Wen-Chien Chen ◽  
Chen-Ju Fu ◽  
Chi-Chien Niu
Keyword(s):  
Clinical Outcome ◽  
Minimally Invasive ◽  
Muscle Function ◽  
Lumbar Fusion ◽  
Muscle Performance ◽  
Functional Score ◽  
Back Muscle ◽  
Fusion Surgery ◽  
Lumbar Fusion Surgery ◽  
Significant Difference

Study Design: Prospective study. Objective: Minimally-invasive lumbar fusion surgery (MIS) is a viable alternative to conventional open surgery (COS) for spinal disorders. Although MIS seems to be associated with less para-spinal muscle trauma, the actual back muscle performance after MIS and COS remain controversial. This study investigated post-operative para-spinal muscle performance, and the correlation between muscle dysfunction and clinical outcome. Methods: In this prospective, non-randomized control study, 50 patients were enrolled and split into 2 groups: COS and MIS. We established a biomechanical model of the para-spinal muscle in the lumbar spine using electromyography (EMG) and specific muscle function tests. Functional outcomes were also reviewed and analyzed. All patients underwent EMG pre-operatively, and at 3 months and 1 year post-operatively. The para-spinal muscle performance was investigated by comparing the back muscle co-contraction ratio and the load transmission zone to the pre-operative data. Results: Twenty-one patients in the COS group and 25 in the MIS group completed the study. Both groups showed a significant improved functional score. The abdominal and back muscle strengths were decreased post-operatively, and were then increased at 12 months post-operatively in both groups. During the perturbed balance task and static task, the MIS group exhibited a trend of recovery in comparison with the COS group. But, the back muscle performance at 12 months was poorer than the pre-op performance in both groups. Conclusions: There was no significant difference in clinical outcome and para-spinal muscle performance between groups. In both methods, the global muscle function had declined post-operatively.

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