Spine surgery patients less likely to be opioid dependent after surgery
(University of Louisville) Spine surgeons and researchers at UofL, concerned about potential opioid misuse resulting from pain management related to surgery, have discovered positive news in a study of back surgery patients. The study, conducted by researchers in the UofL Department of Neurological Surgery, concludes that patients undergoing surgery for degenerative spondylolisthesis are less likely to be dependent on opioids after than before the surgery.
Conclusions: Lower back pain is a serious health problem, and this review article will help educate physicians and physiotherapists dealing with LBP in the options of evidence-based treatment. Ultimately, the article introduces and postulates the need to systematize therapeutic procedures in LBP therapy, with a long-term perspective. PMID: 32256908 [PubMed - as supplied by publisher]
CONCLUSIONS: A high index of suspicion is needed to diagnose sacral insufficiency fracture after LS arthrodesis. A trial of conservative management is reasonable for select patients; potential surgical indications include refractory pain, neurological deficit, fracture nonunion with anterolisthesis or kyphotic angulation, L5-S1 pseudarthrosis, and spinopelvic malalignment. Lumbopelvic fixation with iliac screws may be effective salvage treatment to allow fracture healing and symptom improvement. High-risk patients may benefit from prophylactic lumbopelvic fixation at the time of index LS arthrodesis. PMID: 32217798 [P...
e A Abstract OBJECTIVE: Minimally invasive posterior segmental instrumentation and intra-articular fusion with the Facet Wedge device. INDICATIONS: All fusion indications in degenerative disc disease without significant translational instability, postnucleotomy syndrome, spondylarthrosis, discitis. CONTRAINDICATIONS: Translatory instabilities, status after decompression with partial facet joint resection, spondylolysis in the affected segment. SURGICAL TECHNIQUE: Through a 3 cm skin incision, blunt transmuscular approach to the corresponding facet joint L1/2 to L5/S1. Opening of the joint cap...
CONCLUSIONS: Female patients undergoing surgery for lumbar degenerative disease (disc degeneration, disc herniation, spondylolisthesis, and spinal canal stenosis) have worse absolute preoperative pain, disability, and HRQoL. Following surgery, females have worse absolute pain, disability, and HRQoL, but demonstrate an equal or greater interval change compared to males. Further studies should examine gender differences in preoperative workup and clinical course. PMID: 32005013 [PubMed - as supplied by publisher]
Conclusions: These preliminary results show that PRF accelerates the rate of fusion in low-grade lytic spondylolisthesis in short-term follow-up.
CONCLUSIONS: The results of this 11-year follow-up study demonstrate that, in patients with spinal stenosis and degenerative spondylolisthesis, decompression and posterior arthroplasty maintain clinical improvement and radiological stability. PMID: 31585417 [PubMed - as supplied by publisher]
Although epidural steroid injection (ESI) has been shown to provide adequate pain relief for degenerative spondylolisthesis patients in treatment regimens up to months, it remains unclear whether the use of ESI affects the rate of crossover from nonoperative to operative management.
A variety of nonoperative therapies are attempted for pain management in patients with symptomatic lumbar stenosis or spondylolisthesis prior to surgery. The costs and utilization of maximal nonoperative therapy (MNT) remains unknown.
This article summarizes the guidelines for the treatment of lumbar spondylolisthesis.
This article focuses on lateral lumbar interbody fusion (LLIF). It represents a minimally invasive approach that affords surgeons an increased ability to restore disc height, indirectly decompress the neural elements, and affect global spinal alignment. As the role for circumferential minimally invasive spine surgery continues to expand, the use of LLIF in the setting of spondylolisthesis —and other pathologies—will continue to represent a robust fusion option.