scholarly journals Effect of Adding Calcitonin to Translaminar Epidural Steroid in Degenerative Lumbar Spinal Canal Stenosis

2016 ◽  
Vol 3;19 (3;3) ◽  
pp. 139-146
Author(s):  
Yasser M. Amr
Keyword(s):  
Local Anesthetic ◽  
Spinal Canal ◽  
Spinal Canal Stenosis ◽  
Walking Distance ◽  
Lumbar Spinal Canal Stenosis ◽  
Canal Stenosis ◽  
Lumbar Spinal Canal ◽  
One Year ◽  
Lumbar Spinal ◽  
Epidural Steroid

Background: Spinal canal stenosis is one of the most common causes of low back pain and disability. Its management varies from surgical to conservative, and the indications for ideal management are not clearly defined. Objectives: This study was conducted to evaluate the effect of adding calcitonin to local anesthetic and corticosteroid in epidural injection for patients suffering from degenerative lumbar spinal canal stenosis. Study Design: Randomized double-blind clinical trial. Setting: Hospital outpatient setting. Methods: One hundred thirty-two patients with degenerative spinal canal stenosis were randomly allocated into 2 groups. Group I received C-arm guided epidural injection of local anesthetic and corticosteroid and Group II received 50 international unit calcitonin added to the mixture of local anesthetic and corticosteroid. Both groups received 2 sets of injections, one week apart. Visual analogue scale for pain during movement and walking distance until incidence of neurogenic claudication have been used for pain assessment, and Oswestry Low Back Pain Disability Questionnaire and analgesic consumption were evaluated for one year. Results: Both groups showed comparable benefits regarding improvement in pain intensity, walking distance, Oswestry scale, and analgesic consumption during the first month follow-up period. These beneficial effects continued in calcitonin group for one year. Limitations: The present study patients would be graded as having mild or at worst moderate stenosis. So, the present study did not examine the efficacy of epidural calcitonin in severe spinal canal stenosis and did not stratify the results according to degree of stenosis which would also have been useful in determining the validity of calcitonin in different degrees of stenosis. Conclusion: Adding calcitonin to epidural steroid and local anesthetic injection seems to be more effective than epidural steroid and local anesthesia alone in management of spinal canal stenosis regarding increased walking distance, better Oswestry scale, diminished pain intensity and perception of paresthesia, and less analgesic consumption, all the above mentioned benefits continued up to one year. So, epidural calcitonin may be considered as a new therapeutic modality in the management of pain in spinal canal stenosis. Key words: Calcitonin, epidural steroid, lumbar, spinal canal stenosis

Pudendal Nerve Electroacupuncture for Lumbar Spinal Canal Stenosis – a Case Series

2008 ◽  
Vol 26 (3) ◽  
pp. 140-144 ◽  
Author(s):  
Motohiro Inoue ◽  
Tatsuya Hojo ◽  
Miwa Nakajima ◽  
Hiroshi Kitakoji ◽  
Megumi Itoi ◽  
...  
Keyword(s):  
Lower Limb ◽  
Spinal Canal ◽  
Pudendal Nerve ◽  
Spinal Canal Stenosis ◽  
Walking Distance ◽  
Lumbar Spinal Canal Stenosis ◽  
Lower Limb Muscles ◽  
Canal Stenosis ◽  
Lumbar Spinal Canal ◽  
Lumbar Spinal

Objective To investigate the effectiveness of pudendal nerve electroacupuncture for lumbar and lower limb symptoms in patients with lumbar spinal canal stenosis for whom acupuncture of the lumbar and lower limb muscles had been ineffective. Methods Nine patients with lumbar spinal canal stenosis for whom conventional acupuncture at the lumbar and lower limb muscles had no effect. Pudendal nerve electroacupuncture was performed eight times (once per week). VAS scores and continuous walking distance were used to evaluate changes in symptoms. Results The following changes in symptoms occurred after pudendal nerve electroacupuncture: low back pain was improved from 45.3±17.4mm (mean ± SD) to 39.2±14.0mm, lower limb pain was improved from 61.1±5.6mm to 35.4±11.9mm, lower limb dysaesthesia was improved from 63.9±8.4mm to 46.9±16.2mm, and continuous walking distance was improved from 100.0±35.4m to 250.0±136.9m. Conclusion Pudendal nerve electroacupuncture may be an effective treatment for lumbar and lower limb symptoms due to spinal canal stenosis, and is potentially useful in patients who have not responded to conventional acupuncture.

scholarly journals Wild-type transthyretin amyloid cardiomyopathy complicated by spinal canal stenosis, carpal tunnel syndrome, and rotator cuff tears: a case report

2020 ◽  
Author(s):  
Seiji Takashio ◽  
Masato Nishi ◽  
Yuichiro Tsuruta ◽  
Kenichi Tsujita
Keyword(s):  
Rotator Cuff ◽  
Spinal Canal ◽  
Spinal Canal Stenosis ◽  
Rotator Cuff Tears ◽  
Lumbar Spinal Canal Stenosis ◽  
Canal Stenosis ◽  
Tunnel Syndrome ◽  
Amyloid Cardiomyopathy ◽  
Lumbar Spinal Canal ◽  
Lumbar Spinal

Abstract Background Wild-type transthyretin amyloid cardiomyopathy (ATTRwt-CM) is receiving increasing attention due to the availability of novel treatment options. Carpal tunnel syndrome (CTS) and lumbar spinal canal stenosis are known early symptoms of transthyretin (TTR) amyloidosis preceding the cardiac involvement and are considered as ‘Red Flags’ for transthyretin amyloid cardiomyopathy (ATTR-CM). Case summary A 67-year-old man with a history of lumbar spinal canal stenosis for the last 10 years, right rotator cuff tears for the last 4 years, and bilateral CTS for the last 1 year was scheduled for orthopaedic surgery for lumbar spinal canal stenosis. Investigations revealed severe left ventricular hypertrophy and hypertroponinaemia, which were suggestive of cardiac amyloidosis. Cardiac magnetic resonance imaging and 99mTc-labelled pyrophosphate scintigraphy demonstrated positive findings for ATTR-CM. Transthyretin deposition was found in both the myocardium and the yellow ligamentum excised during surgery. There was no transthyretin mutation on genetic testing. The final diagnosis was ATTRwt-CM. Discussion Transthyretin deposition in the ligaments or tendons has been observed in a number of patients with CTS, spinal canal stenosis, and rotator cuff tears. These orthopaedic diseases are predictive for the future occurrence of ATTR-CM. In addition, the coexistence of these multiple diseases might strongly predict ATTR-CM. This knowledge needs to be shared with orthopaedicians and cardiologists for the early diagnosis of ATTR-CM.

scholarly journals Surgical treatments for lumbar spinal canal stenosis.

1987 ◽  
Vol 35 (3) ◽  
pp. 888-891
Author(s):  
Hirofumi Harada ◽  
Kenji Utsunomiya ◽  
Shougo Masumi ◽  
Nobutaka Kuroya
Keyword(s):  
Spinal Canal ◽  
Spinal Canal Stenosis ◽  
Lumbar Spinal Canal Stenosis ◽  
Canal Stenosis ◽  
Lumbar Spinal Canal ◽  
Lumbar Spinal ◽  
Surgical Treatments

scholarly journals Posterior Decompression Usign METRx-MD System for Lumbar Spinal Canal Stenosis

2006 ◽  
Vol 55 (4) ◽  
pp. 467-470
Author(s):  
Masaki Yoh ◽  
Masayoshi Oga ◽  
Junichi Arima ◽  
Ko Ikuta ◽  
Soichiro Nakano ◽  
...  
Keyword(s):  
Spinal Canal ◽  
Spinal Canal Stenosis ◽  
Lumbar Spinal Canal Stenosis ◽  
Posterior Decompression ◽  
Canal Stenosis ◽  
Lumbar Spinal Canal ◽  
Lumbar Spinal

scholarly journals Clinical and Roentgenographic Studies for the Lumbar Spinal Canal Stenosis

1974 ◽  
Vol 23 (3) ◽  
pp. 272-275
Author(s):  
M. Naruo ◽  
H. Takahashi ◽  
T. Higashihara ◽  
T. Sakae ◽  
K. Morimoto ◽  
...  
Keyword(s):  
Spinal Canal ◽  
Spinal Canal Stenosis ◽  
Lumbar Spinal Canal Stenosis ◽  
Canal Stenosis ◽  
Lumbar Spinal Canal ◽  
Lumbar Spinal

scholarly journals Clinical and radiological studies of lumbar spinal canal stenosis.

1984 ◽  
Vol 32 (1) ◽  
pp. 163-167
Author(s):  
S. Yano ◽  
T. Yano ◽  
H. Hieda ◽  
N. Nagata ◽  
Y. Ishibashi ◽  
...  
Keyword(s):  
Spinal Canal ◽  
Spinal Canal Stenosis ◽  
Lumbar Spinal Canal Stenosis ◽  
Canal Stenosis ◽  
Lumbar Spinal Canal ◽  
Lumbar Spinal ◽  
Radiological Studies

scholarly journals Outcome of decompressive operative procedure in the treatment of degenerative lumbar spinal canal stenosis: experience of managing consecutive 25 cases

2020 ◽  
Vol 10 (2) ◽  
pp. 103-107
Author(s):  
Apel Chandra Saha ◽  
Md Hasan Masud ◽  
Md Abdul Haque ◽  
Mohammad Zulfiqur Haider Sarker
Keyword(s):  
Spinal Canal ◽  
Spinal Canal Stenosis ◽  
City Hospital ◽  
Lumbar Spinal Canal Stenosis ◽  
Interventional Study ◽  
Average Hospital ◽  
Canal Stenosis ◽  
Lumbar Spinal Canal ◽  
Lumbar Spinal

Background: Lumbar spinal canal stenosis (LSCS) is a common medical disorder due to degenerative changesin the middle age and older individual. In this condition, narrowing of lumbar spinal canal and nerve rootcanal leads to painful, debilitating compression of spinal nerves and blood vessels. Decompressive surgery inlumbar spinal canal stenosis is one of modern methods of treatment.The objective of this study was to evaluate the outcome of decompressive operative management in degenerativelumbar spinal canal stenosis. Methods: Thiswas a prospective interventional study carried out at National Institute of Traumatology andOrthopaedic Rehabilitation (NITOR) and City Hospital, Lalmatia, Dhaka from October 2012 to December2014.Total number of patients were 25 who underwent decompressive surgical procedures. Each of patientswas evaluated by the visual analogue scale (VAS) for pain, disability by using Oswestry disability index (ODI)and ModifiedMacnab Criteria (MMC)for assessment of improvement. Results: This was a prospective interventional study carried out at National Institute Of Traumatology and OrthopaedicRehabilitation (NITOR) and City hospital, Lalmatia, Dhaka from October 2012 to December 2014. Out of 25patients, 19 patients(76%)were male and 6 patients (24%) were female, age ranged from 38-65 years with the meanage 48.50 ± 8.65 years. Sixteen (64%) patients were manual worker and 9 patients (36%) were sedentary worker.Sixteen (64%) patients had multilevel stenosis and 9 patients (36%) had single level stenosis. The mean follow upduration was 1.5 years (range: 1-3 years). Mean estimated blood loss was 150ml (range : 100-200ml), meansurgery time was 130mutes (range: 80-180min) and average hospital stay was 7 days (range: 4-10 days). Only 1patient (4%) had discitis, 1 patient (4%) had superficial wound infection and 1 patient (4%) had dural tear. AsMMC, 21 (84%) patients was poor before operation and after operation at 12 months follow up 8 patients (32%)had excellent, 12 patients (48%) had good, 4 patients (16%) had fair and 1 patient (4%) had poor functionaloutcome. Mean (SD) ODI were 75.40 (± 5.01) before operation and reduced to 8.36 (± 13.54) after operation at 3rd(12 month) follow up. Mean (SD) VAS was 7.12 (± 0.86) before operation and reduced to 1.46 (± 1.31) afteroperation at 3rd (12 month) follow up. Twenty (80%) patients had satisfactory functional outcome. Conclusion: Decompressive operation is an effective, safe and acceptable method of treatment in degenerativelumbar spinal canal stenosis (LSCS). Birdem Med J 2020; 10(2): 103-107

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