Comparison of Stand-alone Lateral Lumbar Interbody Fusion Versus Open Laminectomy and Posterolateral Instrumented Fusion in the Treatment of Adjacent Segment Disease Following Previous Lumbar Fusion Surgery

Study Design. Retrospective cohort study. Objective. The aim of this study was to compare clinical and radiographic outcomes of patients who underwent stand-alone lateral lumbar interbody fusion (LLIF) to those who underwent posterolateral fusion (PLF) for symptomatic adjacent segment disease (ASD). Summary of Background Data. Recent studies have suggested that LLIF can successfully treat ASD; however, there are no studies to date that compare LLIF with the traditional open PLF in this cohort. Methods. A total of 47 consecutive patients who underwent LLIF or PLF for symptomatic ASD between January 2007 and August 2016 after failure of conservative management were reviewed for this study. Patient-reported outcomes (PROs) were collected on all patients at preoperative, postoperative, and most recent post-operative visit using the Oswestry Disability Index, Visual Analog Scale (VAS)–Back, and VAS–Leg surveys. Preoperative, immediate postoperative, and most recent postoperative radiographs were assessed for pelvic incidence, fusion, intervertebral disc height, segmental and overall lumbar lordosis (LL). Symptomatic ASD was diagnosed if back pain, neurogenic claudication, or lower extremity radiculopathy presented following a previous lumbar fusion. Preoperative plain radiographs were evaluated for evidence of adjacent segment degeneration. Results. A total of 47 patients (23 LLIF, 24 PLF) met inclusion criteria. Operative times (P 
Source: Spine - Category: Orthopaedics Tags: SURGERY Source Type: research

Related Links:

We describe the most highly recommended generic and disease-specific PRO tools in SCD and discuss the challenges of incorporating them in clinical practice. EXPERT OPINION: PRO measures are essential to incorporate into SCD clinical trials either as primary or secondary outcomes. The use of PRO measures in SCD facilitates a patient-centered approach, which is likely to lead to improved outcomes. Significant challenges remain in adapting PRO tools to routine clinical use and in developing countries. PMID: 33034214 [PubMed - as supplied by publisher]
Source: Expert Review of Hematology - Category: Hematology Tags: Expert Rev Hematol Source Type: research
Currently in fellowship doing bread/butter procedures (MBB, epidurals, PNB, few SCS/PNS trials, etc.) and just interviewed at a private practice spot where they do a lot of procedures that I will have not done any training in prior to graduating (e.g. IT pump, SI fusion, Vertiflex, Kypho, MILD, Discectomy, lots of SCS/PNS trials etc) and significant amount of "OR pain procedures" at a very busy practice seeing 30-40 pts/day - how many of you are commonly performing these procedures and are... private practice concern
Source: Student Doctor Network - Category: Universities & Medical Training Authors: Tags: Pain Medicine Source Type: forums
Conclusions: Spinal instability is the nodal point of pathogenesis of spinal degeneration-related AIDLS. Only fixation of the involved spinal segments is necessary, and decompression by bone or soft-tissue resection is not necessary.
Source: Journal of Craniovertebral Junction and Spine - Category: Orthopaedics Authors: Source Type: research
ConclusionLSS is frequent in lumbar scoliosis. Relationships exist between curve characteristics and symptomatic LSS in lumbar scoliosis; especially, concavity of the lumbosacral contra-curve and the junctional level between the lumbar curve and the lumbosacral contra-curve. Therefore, accurate analysis of stenosis in ASD seems mandatory, to at least perform decompression because perfect planned treatment for stenosis and scoliosis correction might not always be possible because of the patient's general health status.Level of EvidenceLevel 4.
Source: Spine Deformity - Category: Orthopaedics Source Type: research
Study Design. Prospective, cohort study. Objective. Demonstrate validity of Patient reported outcomes measurement information system (PROMIS) physical function, pain interference, and pain behavior computer adaptive tests (CATs) in surgically treated lumbar stenosis patients. Summary of Background Data. There has been increasing attention given to patient reported outcomes associated with spinal interventions. Historical patient outcome measures have inadequate validation, demonstrate floor/ceiling effects, and infrequently used due to time constraints. PROMIS is an adaptive, responsive National Institutes of Healt...
Source: Spine - Category: Orthopaedics Tags: SURGERY Source Type: research
AbstractSurgical correction of fixed thoracolumbar deformity is usually achieved by estimating the preoperatively planned correction angles during surgery and is therefore prone to inaccuracy. This is particularly problematic in biplanar deformities. To overcome these difficulties, 3D model for planning, preparation, and simulation of an asymmetric pedicle subtraction osteotomy (aPSO) was printed and used to realign coronal and sagittal balance in case of rigid degenerative kyphoscoliosis. A 59-year-old woman presented with severe back pain and spinal claudication and was diagnosed with a rigid kyphoscoliosis with multilev...
Source: Neurosurgical Review - Category: Neurosurgery Source Type: research
Discussion: Five participants met criteria for having SLSS. Differences are reported in medians and interquartile ranges. Participants with SLSS reported more global pain, a greater number of comorbid conditions [SLSS: 7.0 (2.0) vs no-SLSS: 4.0 (2.0), P
Source: Journal of Geriatric Physical Therapy - Category: Physiotherapy Tags: Research Reports Source Type: research
This study aimed to investigate whether the restoration of disc dimensions would relieve symptoms of radiculopathy, claudication and back pain. In this retrospective study, patients undergoing XLIF surgery for relief of radicular symptoms or degenerative disc disease were included. Radiologically proven changes were used to assess the modes of degeneration. Objective measures such as the Visual Analogue Scale (VAS) for back and legs and the Oswestry Disability Index (ODI) were used. Complications were collated post-operatively from clinical notes and outpatient appointments. Twenty-three consecutive patients were included,...
Source: Journal of Clinical Neuroscience - Category: Neuroscience Source Type: research
Conclusions: Patients with smaller PI tended to be restored higher, and those patients with a larger PI were more likely to be restored lower. For patients with normal sagittal balance, the surgical outcomes in the treatment of low-grade lumbar degenerative spondylolisthesis with spinal fusion are not correlated with restoration of the LL.
Source: Journal of Spinal Disorders and Techniques - Category: Surgery Tags: Primary Research Source Type: research
Publication date: Available online 23 May 2015 Source:Formosan Journal of Surgery Author(s): Hsien-Ta Hsu , Ming-Hsueh Lee , Kuo-Feng Huang A 56-year-old female patient experienced mild back pain, which radiated to her legs, as well as intermittent claudication for 5 years. The symptoms became more pronounced on sitting and walking, and conservative therapy was ineffective in relieving pain. Preoperative whole-spine X-ray scans revealed degenerative lumbar kyphoscoliosis. Asymmetrical pedicle subtraction osteotomy was performed and a convex-sided posterolateral wedge osteotomy was applied to correct the scoliosis and res...
Source: Formosan Journal of Surgery - Category: Surgery Source Type: research
More News: Back Curves | Back Pain | Brain | Disability | Intermittent Claudication | Laminectomy | Neurology | Neurosurgery | Orthopaedics | Pain | Pain Management | Radiography | Study