Learning curve and clinical outcomes of percutaneous endoscopic transforaminal decompression for lumbar spinal stenosis

AbstractPurposeTo define and analyze the learning curve of percutaneous endoscopic transforaminal decompression (PETD) for lumbar spinal stenosis (LSS).MethodsFrom July 2015 to September 2016, 78 patients underwent PETD; one of whom was converted to open surgery, two were lost, and 75 were included in this study. Clinical results were assessed by using the Oswestry Disability Index (ODI) and visual analog scale (VAS). The learning curve was assessed by a logarithmic curve-fitting regression analysis. Of these 75 patients, 35 were defined as the “early” group, and 40 were defined as the “late” group for comparison.ResultsThe mean follow-up was 25.37  ± 4.71 months. The median operative time gradually decreased from 95 (interquartile range, IQR, 85–110) minutes for the early group to 70 (IQR, 60–80) minutes for the late group (P 
Source: International Orthopaedics - Category: Orthopaedics Source Type: research

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This study included 390 patients with LHD or LSS referred for surgical evaluation after unsuccessful conservative treatment. Nonsuccess was defined as a Roland-Morris Disability score above 4 (0–23) or a Numeric Rating Scale back and leg pain score above 20 (0–60). Uni- and multivariate logistic regression analyses were used to investigate potential predictive factors including sociodemographic characteristics, history findings, levels of pain and disability, and magnetic resonance imaging findings. Results. Rates of nonsuccess at 2 years were approximately 30% in surgically treated patients with LHD, approx...
Source: Spine - Category: Orthopaedics Tags: SURGERY Source Type: research
Conclusions: Paraspinal muscles evaluated with MRI were more significantly associated with the pathology of ASD compared with appendicular skeletal muscle evaluations with dual-energy x-ray absorptiometry. The present study indicates that multifidus and erector muscles significantly influenced the maintenance of the pelvic alignment. Level of Evidence: Level III.
Source: Journal of Spinal Disorders and Techniques - Category: Surgery Tags: Primary Research Source Type: research
AbstractObjectiveTo estimate the effect of the knee bolster use during an MRI on lumbar spinal stenosis parameters and low back pain-related disability.MethodsA repeated-measurement study of 27 males and 19 females with mean age 55.78  ± 14.36, referred for an MRI of the lumbar spine due to low back pain, performed with and without standard knee bolster. A radiologist evaluated the lumbar lordosis Cobb’s angle, the cross-sectional area of the right and left intervertebral foramina and spinal canal at L1-L2, L2-L3, L3-L4 sp inal levels. Spinal symptoms were evaluated by the Oswestry Disability Que...
Source: Skeletal Radiology - Category: Radiology Source Type: research
The aim of the study was to evaluate the clinical effect of the limited area decompression, intervertebral fusion, and pedicle screw fixation for treating degenerative lumbar spinal stenosis (DLSS) with instability. Hemilaminectomy decompression, intervertebral fusion, and pedicle screw fixation for treating DLSS with instability as the control group. Follow-up of 54 patients (26 males and 28 females; average age, 59.74 ± 10.38 years) with DLSS with instability treated by limited area decompression, intervertebral fusion, and pedicle screw fixation (LIFP group), and 52 patients as control group with hemilaminec...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research
This study aimed to investigate the gender difference in pre- and postoperative health-related quality of life (HRQOL) in patients who have had decompression surgery for lumbar spinal stenosis (LSS). Overview of Literature: Gender differences may contribute to variations in disease presentations and health outcomes. The influence of gender on pre- and postoperative HRQOL in spinal disorders remains unclear. Methods: We reviewed 125 patients (79 men and 46 women) who had lumbar spinous process splitting laminectomy (LSPSL) for LSS. We assessed the following clinical information: Japanese Orthopedic Association (JOA)...
Source: Asian Spine Journal - Category: Orthopaedics Tags: Asian Spine J Source Type: research
Rosenbaum J Abstract PURPOSE OF THE STUDY Lumbar spinal stenosis (LSS) is a serious and fairly frequent disorder with prevalence increasing with age which often results in a disability. The surgical procedures are often very risky due to the greater age of patients with severe stenosis and their comorbidities. The study aimed to assess the functional outcomes and complications in patients who underwent surgical treatment for LSS at one year postoperatively and to identify the differences in the functional outcomes, if any, in dependence on the number of operated segments. MATERIAL AND METHODS It was a prospective ...
Source: Acta Orthopaedica - Category: Orthopaedics Authors: Tags: Acta Chir Orthop Traumatol Cech Source Type: research
Conclusions: Endoscope-assisted and microscope-assisted tubular discectomies resulted in similar clinical outcomes for LDH, while the microscope-assisted surgery may relate to better recovery rate for LSS, less surgical time, and less intraoperative dural tear. PMID: 31179327 [PubMed - in process]
Source: Biomed Res - Category: Research Authors: Tags: Biomed Res Int Source Type: research
Abstract OBJECTIVEPatients with lumbar spinal stenosis (LSS) tend to bend forward to relieve neurological symptoms. They therefore have a positive sagittal vertical axis (SVA). The importance of the SVA value is well known in the field of adult spinal deformity; however, little is known about its impact on LSS. The authors sought to investigate the impact of sagittal spinopelvic alignment on clinical outcome and health-related quality of life (HRQOL) after decompression surgery for LSS.METHODSThe authors retrospectively reviewed 83 patients who underwent lumbar decompression without fusion between January 2014 and...
Source: Journal of Neurosurgery.Spine - Category: Neurosurgery Authors: Tags: J Neurosurg Spine Source Type: research
Lower back pain (LBP) is prevalent in Western society and a common reason for a medical consultation [1,2]. The resultant reduction of life quality, work performance and social interactions for affected persons has led to intensive research efforts focused on the development of new treatment methods [3]. Besides non-specific back pain, several disabilities with an existing morphological correlate can be the cause of these symptoms, for instance lumbar spinal stenosis or degenerative spondylolisthesis [4].
Source: Gait and Posture - Category: Orthopaedics Authors: Source Type: research
J Neurol Surg A Cent Eur Neurosurg DOI: 10.1055/s-0038-1655760 Background Lumbar spinal stenosis (LSS) and low-grade degenerative spondylolisthesis are frequently associated with facet joint degeneration, considered the main cause of low back pain. Surgery is the treatment of choice in patients affected by LSS unresponsive to conservative treatment. The aim of this study was to evaluate the clinical and radiologic outcome of patients treated with posterior decompression and transfacet fixation for single-level LSS and facet joint degeneration. Methods A total of 25 patients between May 2015 and June 2016 af...
Source: Journal of Neurological Surgery Part A: Central European Neurosurgery - Category: Neurosurgery Authors: Tags: Original Article Source Type: research
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