scholarly journals Minimally Invasive L5 Corpectomy with Navigated Expandable Vertebral Cage: A Technical Note

2021 ◽  
Vol 11 (9) ◽  
pp. 1241
Author(s):  
Taro Yamauchi ◽  
Ashish Jaiswal ◽  
Masato Tanaka ◽  
Yoshihiro Fujiwara ◽  
Yoshiaki Oda ◽  
...  
Keyword(s):  
Back Pain ◽  
Minimally Invasive ◽  
Lower Back Pain ◽  
Revision Surgery ◽  
Leg Pain ◽  
Decompression Surgery ◽  
Intraoperative Radiation ◽  
Lower Back ◽  
Estimated Blood Loss ◽  
L5 Corpectomy

Background: Conventional L5 corpectomy requires a large incision and an extended period of intraoperative fluoroscopy. We describe herein a new L5 corpectomy technique. Methods: A 79-year-old woman was referred to our hospital for leg pain and lower back pain due to an L5 vertebral fracture. Her daily life had been affected by severe lower back pain and sciatica for more than 2 months. We initially performed simple decompression surgery, but this proved effective for only 10 months. Results: For revision surgery, the patient underwent minimally invasive L5 corpectomy with a navigated expandable cage without fluoroscopy. The second surgery took 215 min, and estimated blood loss was 750 mL. The revision surgery proved successful, and the patient could then walk using a cane. In terms of clinical outcomes, the Oswestry Disability Index improved from 66% to 24%, and the visual analog scale score for lower back pain improved from 84 to 31 mm at the 1-year follow-up. Conclusions: Minimally invasive L5 corpectomy with a navigated expandable vertebral cage is effective for reducing cage misplacement and surgical invasiveness. With this new technique, surgeons and operating room staff can avoid the risk of adverse events due to intraoperative radiation exposure.

How Decompression Surgery Improves the Lower Back Pain in Patient With Lumbar Degenerative Stenosis

Spine ◽  
2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Mitsuru Yagi ◽  
Satoshi Suzuki ◽  
Nori Satoshi ◽  
Yohei Takahashi ◽  
Osahiko Tsuji ◽  
...  
Keyword(s):  
Back Pain ◽  
Lower Back Pain ◽  
Decompression Surgery ◽  
Lower Back

scholarly journals Osteoporotic vertebral fracture misdiagnosed as “normal postoperative phenomenon” in post decompression surgery: a case report

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Li-sheng Hou ◽  
Dong Zhang ◽  
Feng Ge ◽  
Hai-feng Li ◽  
Tian-jun Gao
Keyword(s):  
Back Pain ◽  
Vertebral Fracture ◽  
Lower Back Pain ◽  
Early Stage ◽  
Decompression Surgery ◽  
Spinal Diseases ◽  
Osteoporotic Vertebral Fracture ◽  
Early Recovery ◽  
Lower Back ◽  
First Case

Abstract Background Previous research and published literature indicate that some patients with spinal diseases who underwent percutaneous transforaminal endoscopic decompression (PTED) still suffer some discomfort in the early recovery stage in the form of pain, stiffness, and swelling. These are usually considered minor residual symptoms or normal postoperative phenomenon (NPF) in the clinic, occur frequently, and are acknowledged by surgeons worldwide. To the best of our knowledge, we report the first case of a patient who had an osteoporotic vertebral fracture (OVF) misdiagnosed as NPF after she underwent PTED as a result of lumbar disc herniation (LDH). Case presentation A 71-year-old female with Parkinson’s disease who presented with lower back pain radiating to the legs was diagnosed as LDH in L4–5, after which a PTED of L4–5 was performed, with temporary alleviation of symptoms. However, severe lower back pain recurred. Unfortunately, the recurred pain initially misdiagnosed as NPF, in fact, was finally confirmed to be OVF by CT-scan. OVF in the early stage of post-PTED seldom occurs and is rarely reported in the literature. With a percutaneous vertebroplasty, the pain was significantly relieved, and she resumed walking. After 36-weeks of follow-up, the pain improved satisfactorily. Conclusion Doctors should not immediately diagnose a relapse of back pain following PTED as NPF, and hands-on careful physical and imaging examinations are necessary to manage recurring pain rightly and timely.

scholarly journals Minimally Invasive Tubular Lumbar Discectomy Versus Conventional Open Lumbar Discectomy: An Observational Study From the Canadian Spine Outcomes and Research Network

2021 ◽  
pp. 219256822110298
Author(s):  
Nathan Evaniew ◽  
Andrew Bogle ◽  
Alex Soroceanu ◽  
W. Bradley Jacobs ◽  
Roger Cho ◽  
...  
Keyword(s):  
Back Pain ◽  
Blood Loss ◽  
Adverse Events ◽  
Minimally Invasive ◽  
Operating Time ◽  
Lumbar Discectomy ◽  
Research Network ◽  
Leg Pain ◽  
Estimated Blood Loss ◽  
Same Day Discharge

Study Design: Retrospective cohort study. Objective: We evaluated the effectiveness of minimally invasive (MIS) tubular discectomy in comparison to conventional open surgery among patients enrolled in the Canadian Spine Outcomes and Research Network (CSORN). Methods: We performed an observational analysis of data that was prospectively collected. We implemented Minimum Clinically Important Differences (MCIDs), and we adjusted for potential confounders with multiple logistic regression. Adverse events were collected according to the Spinal Adverse Events Severity (SAVES) protocol. Results: Three hundred thirty-nine (62%) patients underwent MIS tubular discectomy and 211 (38%) underwent conventional open discectomy. There were no significant differences between groups for improvement of leg pain and disability, but the MIS technique was associated with reduced odds of achieving the MCID for back pain (OR 0.66, 95% CI 0.44 to 0.99, P < 0.05). We identified statistically significant differences in favor of MIS for each of operating time (MIS mean (SD) 72.2 minutes (30.0) vs open 93.5 (40.9)), estimated blood loss (MIS 37.9 mL (36.7) vs open 76.8 (71.4)), length of stay in hospital (MIS 73% same-day discharge vs open 40%), rates of incidental durotomy (MIS 4% vs open 8%), and wound-related complications (MIS 3% vs open 9%); but not for overall rates of reoperation. Conclusions: Open and MIS techniques yielded similar improvements of leg pain and disability at up to 12 months of follow-up, but MIS patients were less likely to experience improvement of associated back pain. Small differences favored MIS for operating time, blood loss, and adverse events but may have limited clinical importance.

scholarly journals Relief of Lower Back and Leg Pain after Myelography

2016 ◽  
Vol 10 (1) ◽  
pp. 539-542
Author(s):  
Rui Guo ◽  
Toshihiko Sakakibara ◽  
Tetsutaro Mizuno ◽  
Koji Akeda ◽  
Tetsushi Kondo ◽  
...  
Keyword(s):  
Back Pain ◽  
Intermittent Claudication ◽  
Lower Back Pain ◽  
Adverse Reactions ◽  
Leg Pain ◽  
Mri Findings ◽  
Spinal Disorder ◽  
Lower Back ◽  
Magnetic Resonance Imaging Mri ◽  
Lumbar Spinal

Introduction: It is well-known that many patients will have adverse reactions such as headache and nausea after undergoing myelography, but we have often seen cases where symptoms such as lower back pain and leg pain were alleviated following myelography. To the best of our knowledge, such clinical cases of post-myelographic alleviation have not been reported. Materials and Methods: A total of 325 patients with a degenerative lumbar spinal disorder who underwent myelography were prospectively investigated at four hospitals from April 2012 to March 2014 to survey the post-myelographic alleviation of lower back and leg pain prospectively. The severities of lower back pain, leg pain and numbness of the lower extremities were evaluated and intermittent claudication distance was measured before myelography. The magnetic resonance imaging (MRI) findings and myelographic findings were also evaluated for the patients that their symptoms were improved. Results: Thirty-five of 325 cases (10.8%) of these patients had their symptoms alleviated after undergoing myelography; 26 cases of lower back pain, two cases of leg pain, two cases of numbness of the lower extremity, and five cases of intermittent claudication. Conclusion: In the patients of a degenerative lumbar spinal disorder, about 10% cases with lower back pain or intermittent claudication had post-myelographic alleviation. Intradural injection therapy might be a therapeutic method to alleviate these symptoms.

Unexpected cause of leg pain in a patient with lower back pain

2017 ◽  
Vol 65 (6) ◽  
pp. 1418
Author(s):  
Maria Zakharkina ◽  
Marine Tanashyan ◽  
Polina Kuznetsova ◽  
Andrey Chechetkin ◽  
Natalia Vuytsik
Keyword(s):  
Back Pain ◽  
Lower Back Pain ◽  
Leg Pain ◽  
Lower Back

scholarly journals Triangular Fixation to Prevent Proximal Screw Pullout in Adult Spinal Deformity Surgery: A Technical Note

2021 ◽  
Author(s):  
Masato Tanaka ◽  
Rahul Mehta ◽  
Taro Yamauchi ◽  
Shinya Arataki ◽  
Koji Uotani ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Blood Loss ◽  
Minimally Invasive ◽  
Adult Spinal Deformity ◽  
Operation Time ◽  
Low Back ◽  
Lower Back ◽  
Estimated Blood Loss ◽  
Proximal Screw

Abstract Background Adult spinal deformity (ASD) is caused by spinal malalignment and results in severe low back pain, neurological dysfunction, and severe deformity. Proximal screw back-out represents a difficult problem in minimally invasive ASD surgery. We describe a novel technique to prevent screw pullout in ASD. Methods A 71-year-old woman was referred to our hospital with severe low back pain and gait difficulty. Her daily life had been affected by severe lower back pain for more than 6 months. Standing radiograms indicated severe kyphoscoliosis. Two-stage minimally invasive corrective T10-to-pelvis fixation was performed. Results The first surgery was an L1–S1 C-arm-free oblique lumbar interbody fusion, with an operation time of 3 h 57 min and an estimated blood loss of 240 mL. After 1 week, the second percutaneous pedicle screw (PPS) fixation was performed and proximal screws were inserted under a transdiscal approach (T11) and with a lower angulation trajectory (T10) to enhance pullout strength. For this second surgery, operation time was 3 h 33 min, and estimated blood loss was 320 mL. No postoperative complications or neurological compromise was reported. In terms of clinical outcomes, Oswestry Disability Index improved from 56–24%, and visual analog scale score for lower back pain improved from 62 mm to 24 mm at the 1-year follow-up. Conclusions Minimally invasive circumferential surgery with triangular fixation is effective for preventing proximal screw back-out and surgical invasiveness. With this new technique, surgeons and operating room staff can avoid the risk of adverse events due to intraoperative radiation exposure.

The patient with lower back pain and leg pain with walking

1989 ◽  
pp. 100-108
Author(s):  
Gunnar B. J. Andersson ◽  
Thomas W. McNeill
Keyword(s):  
Back Pain ◽  
Lower Back Pain ◽  
Leg Pain ◽  
Lower Back
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