scholarly journals Awake Endospine Disektomi pada Pasien Lumbar Spinal Stenosis karena Hernia Nucleus Pulposus

2020 ◽  
Vol 9 (2) ◽  
pp. 173-182
Author(s):  
Nuzulul Widyadining Laras ◽  
◽  
Himawan Sasongko ◽  
Keyword(s):  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Sedative Effect ◽  
Stable Phase ◽  
Low Back ◽  
Major Health Problem ◽  
Major Health ◽  
Lumbar Spinal ◽  
Spinal Epidural ◽  
Anesthesia Spinal

Lumbar spinal stenosis (LSS) are symptoms from degradation canalis spinalis vertebrae’s size which pressured nerve inside it. Based on its cause, there are two types of LSS, congenital and degenerative. The patient can experience an unpredictable pain phase as well as a stable phase without pain. Bulging of intervertebralis disc or HNP is one of degenerative LSS. HNP disease is one of the causes of low back pain and is a major health problem. HNP prevalention is 1-2 % from population. One of therapy use to medicate LSS is endospine discectomy. This operation done with general anesthesia (GA) or neuroaxial anesthesia (spinal, epidural). GA preferably used because it caused less side effect like airway obstruction or neural injury. Dexmedetomidine has a sedative effect without the risk of respiratory depression and has an analgesic effect. It can be used to awake endospine methods in dissectomy. In this case report, the writer did awake endospine method to accommodate operator so they could know level of pain and motoric function of patient durante operation.

scholarly journals Predictors of Walking Performance and Walking Capacity in People With Lumbar Spinal Stenosis, Low Back Pain, and Asymptomatic Controls

2012 ◽  
Vol 93 (4) ◽  
pp. 647-653 ◽  
Author(s):  
Christy C. Tomkins-Lane ◽  
Sara Christensen Holz ◽  
Karen S. Yamakawa ◽  
Vaishali V. Phalke ◽  
Doug J. Quint ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Low Back ◽  
Walking Capacity ◽  
Walking Performance ◽  
Lumbar Spinal

scholarly journals Acute cauda equina syndrome due to lumbar spinal stenosis caused by prolonged supine position during cardiac catheterization: a case report

2021 ◽  
pp. 209
Author(s):  
Keyword(s):  
Atrial Fibrillation ◽  
Low Back Pain ◽  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Supine Position ◽  
Bladder Dysfunction ◽  
Cauda Equina ◽  
Lower Limbs ◽  
Low Back ◽  
Lumbar Spinal

Background: Cauda equina syndrome (CES) is a severe neurologic condition marked by progressive loss of function of the neurologic elements in the spinal canal below the termination of the spinal cord. This article reports an instructive case of CES with acute aggravation of neuropathy after catheter ablation for atrial fibrillation. Patient concerns: A 63-year-old Japanese man underwent catheter ablation for atrial fibrillation. Because he complained of severe low back pain and numbness in the posterior of both lower limbs while in the supine position, he was given analgesia with pentazocine and sedated with propofol, and the procedure continued. He was then forced to maintain lumbar extension while in the supine position for 13 hours. After the treatment, he noticed urination disor-der, numbness, and paralysis of both lower limbs. Diagnosis: Neurological findings included sensory impairment and motor deficit of L5 and below, including bowel/bladder dysfunction. Lumbar magnetic resonance imaging showed severe lumbar spinal stenosis at L4-L5. He was diagnosed with CES due to lumbar spinal stenosis. Interventions: The patient received emergency surgery for L4-L5 decompression. Decompression of the spinal canal was achieved 33 hours after the start of catheterization. Outcomes: The patient’s leg symptoms improved immediately after surgery, and he was able to walk with a walker. On postoperative day 6, the urinary catheter was removed. However, he experienced urinary retention and needed intermittent self-directed urination. Five months after surgery, he was able to urinate on his own, and completed the intermittent self-directed urination. Nine months after surgery, his muscle strength had recovered almost completely, and he was able to walk with a cane. However, bladder dysfunction such as frequent urination and residual urination remained 4 years after surgery. Lessons: If the supine position elicits low back pain and leg numbness, the presence of lumbar spinal stenosis should be considered. Forcing patients with such symptoms into a sustained posture can lead to CES.

scholarly journals Prevalence, Spinal Alignment, and Mobility of Lumbar Spinal Stenosis with or without Chronic Low Back Pain: A Community-Dwelling Study

2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
Naohisa Miyakoshi ◽  
Michio Hongo ◽  
Yuji Kasukawa ◽  
Yoshinori Ishikawa ◽  
Yoichi Shimada
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Chronic Low Back Pain ◽  
Community Dwelling ◽  
Computer Assisted ◽  
Low Back ◽  
Spinal Alignment ◽  
Lumbar Spinal

Although lumbar spinal stenosis (LSS) occurs almost universally with aging, little is known regarding its actual prevalence and relationships to chronic low back pain (CLBP) in the general population. The presence of CLBP in subjects with LSS may have negative impacts on spinal alignment and mobility. This study evaluated the prevalence of LSS using a self-administered, self-reported history questionnaire in 630 community-dwelling individuals ≥50 years old. Subjects with LSS were further divided into LSS+CLBP and LSS alone groups, and spinal alignment and mobility were compared using a computer-assisted device. Prevalence of LSS was 10.8% in this cohort. Subjects in the LSS+CLBP group () showed a significantly more kyphotic lumbar spinal alignment with limited lumbar extension (), resulting in a stooped trunk compared to subjects in the LSS alone group (). However, no significant difference in spinal mobility was seen between groups.

Evaluation of postoperative spinal epidural hematoma after microendoscopic posterior decompression for lumbar spinal stenosis: a clinical and magnetic resonance imaging study

2006 ◽  
Vol 5 (5) ◽  
pp. 404-409 ◽  
Author(s):  
Ko Ikuta ◽  
Osamu Tono ◽  
Takayuki Tanaka ◽  
Junichi Arima ◽  
Soichiro Nakano ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Spinal Epidural Hematoma ◽  
Posterior Decompression ◽  
Dural Sac ◽  
Group 2 ◽  
Lumbar Spinal ◽  
Spinal Epidural ◽  
Group 1

Object The incidence of postoperative spinal epidural hematoma (SEH) is low, and to the best of the authors’ knowledge, no researchers have evaluated its actual incidence and clinical features. The purpose of this study was to investigate the clinical consequences of SEH after microendoscopic posterior decompression (MEPD) in patients with lumbar spinal stenosis. Methods Data obtained in 30 patients undergoing MEPD for lumbar spinal stenosis were reviewed. At 1 week after surgery, magnetic resonance (MR) imaging documented SEHs in 10 patients (33% [Group 1]) and no evidence of SEHs in 20 patients (67% [Group 2]). The authors compared MR imaging findings, postoperative morbidities, and clinical outcomes between the groups. Three Group 1 patients had symptomatic SEHs. All symptoms were mild without associated neurological deterioration and spontaneously subsided within 3 weeks of surgery. Magnetic resonance imaging demonstrated spontaneous regression of the SEH in all patients at 3 months after surgery. In Group 1 patients, however, the authors observed less expansion of the dural sac after 1 year despite sufficient widening of the osseous spinal canal. Low-back pain within 1 week of surgery was moderate in Group 1 and mild in Group 2. Improvements at the final follow up were greater in Group 2 patients. Conclusions The incidence of postoperative SEHs may be greater than reported. Postoperative SEHs caused poor expansion of the dural sac despite its spontaneous regression. In addition, postoperative SEHs caused a delay in the patient’s recovery and led to a poor clinical improvement. The prevention of postoperative SEHs might be required to prevent not only neurological deterioration but also a delay in the patient’s recovery.

scholarly journals Can decompression surgery relieve low back pain in patients with lumbar spinal stenosis combined with degenerative lumbar scoliosis?

2013 ◽  
Vol 22 (9) ◽  
pp. 2010-2014 ◽  
Author(s):  
Shunji Tsutsui ◽  
Ryohei Kagotani ◽  
Hiroshi Yamada ◽  
Hiroshi Hashizume ◽  
Akihito Minamide ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Decompression Surgery ◽  
Degenerative Lumbar Scoliosis ◽  
Low Back ◽  
Lumbar Scoliosis ◽  
Lumbar Spinal

scholarly journals Examination Findings and Self-Reported Walking Capacity in Patients With Lumbar Spinal Stenosis

2001 ◽  
Vol 81 (7) ◽  
pp. 1296-1306 ◽  
Author(s):  
Maura D Iversen ◽  
Jeffrey N Katz
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Lower Extremity ◽  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Cauda Equina ◽  
Low Back ◽  
Lower Extremity Weakness ◽  
Walking Capacity ◽  
Lumbar Spinal

AbstractBackground and Purpose. Spinal stenosis is a common, often disabling, condition resulting from compression of the cauda equina and nerve roots. This study was designed to: (1) characterize the impairments of patients with lumbar spinal stenosis (LSS) and (2) to identify predictors of self-reported walking capacity. Subjects. Forty-three patients with symptomatic LSS, from 3 specialty clinics, were evaluated. Twenty-eight subjects (65%) were female. The subjects' median age was 73.6 years (X̄=72.4, SD=10.3, range=45.–90.7), and the median duration of low back pain was 24 months (X̄=36.6, SD=41.6, range=0–216). Methods. Demographic data, medical history, and information about low back pain and symptoms (eg, numbness, tingling, and lower-extremity weakness) were collected using a standardized questionnaire and physical examination. Results. Twenty-two subjects (51%) had lower-extremity weakness, primarily of the extensor hallucis longus muscle. Thirty-five subjects (81%) had absent or decreased neurosensory responses (eg, pinprick, vibration, reflexes), and 28 subjects (66%) reported that they were unable to walk farther than 2 blocks. Women were more likely than men to report difficulties walking, as were subjects with abnormal Romberg test scores and those with greater pain during walking. Discussion and Conclusion. Pain and balance problems appeared to be the primary factors limiting ambulation in our subjects with LSS.

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