Predictors of the need for laminectomy after indirect decompression via initial anterior or lateral lumbar interbody fusion.

Predictors of the need for laminectomy after indirect decompression via initial anterior or lateral lumbar interbody fusion. J Neurosurg Spine. 2020 Jan 24;:1-7 Authors: Park D, Mummaneni PV, Mehra R, Kwon Y, Kim S, Ruan HB, Chou D Abstract OBJECTIVE: The goal of this study was to evaluate factors that are associated with the need for additional posterior direct decompressive surgery after anterior lumbar interbody fusion (ALIF) or lateral lumbar interbody fusion (LLIF). METHODS: Eighty-six adult patients who underwent ALIF or LLIF for degenerative spondylolisthesis and foraminal stenosis were enrolled. Patient factors (age, sex, number of surgery levels, and visual analog scale [VAS] score for leg and back pain); procedure-related factors (cage height and lordosis); and radiographic measurements (disc height [DH]; foraminal height [FH], foraminal area [FA], central canal diameter [CCD], and facet joint degeneration [FD]) were analyzed. All patients underwent staged surgery on 2 different days, with the anterior portion first, followed by the posterior portion. RESULTS: Of 86 patients, 62 underwent posterior decompression and 24 had no posterior decompression. There were no significant differences between groups with regard to age, sex, preoperative VAS score for back pain, cage height, cage angulation, preoperative DH, FH, FA, CCD, and FD (p> 0.05). The group that underwent posterior decompression showed statistically different numbers of t...
Source: Journal of Neurosurgery.Spine - Category: Neurosurgery Authors: Tags: J Neurosurg Spine Source Type: research

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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...
Source: Journal of Neurosurgery.Spine - Category: Neurosurgery Authors: Tags: J Neurosurg Spine Source Type: research
ConclusionInter-rater reliability for 3 raters, evaluating 177 disc levels, was found to be overall acceptable for 6 out of 8 degenerative MRI-findings in the lumbar spine. Ratings of facet joint degeneration and disc contour achieved moderate reliability and was considered unacceptable.
Source: Chiropractic and Manual Therapies - Category: Complementary Medicine Source Type: research
Authors: Selby MS, Gillette A, Raval Y, Taufiq M, Sampson MJ Abstract Modern human bipedality is unique and requires lumbar lordosis, whereas chimpanzees, our closest relatives, have short lumbar spines rendering them incapable of lordosis. To facilitate lordosis, humans have longer lumbar spines, greater lumbosacral angle, dorsally wedged lumbar vertebral bodies, and lumbar zygapophyseal joints with both increasingly coronal orientation and further caudal interfacet distances. These features limit modern lower lumbar spine and lumbosacral joint ailments, albeit imperfectly. The more coronal zygapophyseal orientati...
Source: Journal of the American Osteopathic Association - Category: Complementary Medicine Tags: J Am Osteopath Assoc Source Type: research
Conclusions: A comparison of pre- and post-operative lateral radiographs showed 27° segmental lordosis correction, and intra-operative fluoroscopy showed correlation between extension of the table and segmental lordosis correction. Bilateral facetectomy and TLIF allows for segmental lordosis correction. Use of the hinged table allowed for ideal positioning during the decompression and controlled osteotomy closure with close correlation between table position and segmental alignment.Level of Evidence: V. PMID: 31413679 [PubMed - in process]
Source: Iowa orthopaedic journal - Category: Orthopaedics Tags: Iowa Orthop J Source Type: research
Study Design. A cross-sectional, retrospective cohort study. Objective. To examine the prevalence of the pedicle stress injury, spondylolysis in children and adolescents with low back pain. And secondly, to test the hypothesis that these pathologies are associated with lumbar lordosis angle. Summary of Background Data. The prevalence of the pedicle stress injury has not been investigated in children with low back pain. In recent studies, lumbar lordosis angle was associated with spondylolysis, on the other hand the pedicle stress injury was not investigated yet. Methods. In this retrospective study, 789 consecut...
Source: Spine - Category: Orthopaedics Tags: DIAGNOSTICS Source Type: research
AbstractBackground Scoliosis with spondylolisthesis was described in 4.4 –48%. No information on clinical impact or outcome is available.PurposeTo determine the prevalence of this pathology and to investigate its affect on the course of adolescent idiopathic scoliosis (AIS).MethodsA retrospective comparative study using patients ’ records, radiographs, the national inpatient registry, and Patient-rated outcome measures (PROM): Oswestry disability index (ODI), modif.SRS-24 questionnaire, WHO-Quality of life index (WHOQoL), Numerical rating scale (NRS) for pain. Clinical follow-up time was 4.4 (4.3) years, and ...
Source: European Spine Journal - Category: Orthopaedics Source Type: research
This study included 65 patients with lumbar spondylolisthesis, who underwent either open transpedicular screw fixation (OTPSF) with posterior lumbar interbody fusion (PLIF) (OTPSF group, n = 33) or PPSF with reduction system (PPSFr group, n = 32) after PLIF. The slippage degree (SD); the intervertebral disc height (IDH); lumbar lordosis (LL); and segmental angle (SA) were measured on the follow-up simple lateral radiographs. For pain and functional assessment in patients, visual analogue scale (VAS) scores for low back pain and leg pain, and Oswestry Disability Index (ODI) scores were measured. SA (P 
Source: Journal of Clinical Neuroscience - Category: Neuroscience Source Type: research
Few would have predicted that Tiger Woods would be playing in the P.G.A. Championship this week. He had three failed back surgeries, starting in 2014. He had taken opioids. His astonishing career seemed over.Then he had one more operation, a spinal fusion, the most complex of all, in 2017. And last month he won the Masters, playing the way he used to.An outcome like his from fusion surgery is so rare it is"like winning the lottery," Dr. Sohail K. Mirza, a spine surgeon at Dartmouth, said.The idea behind spinal fusion is to remove a disk — a ring of fibers filled with a nerve-cushioning jelly that joins adja...
Source: Psychology of Pain - Category: Anesthesiology Source Type: blogs
Publication date: Available online 10 May 2019Source: Journal of Clinical NeuroscienceAuthor(s): Xu Zhengkuan, Chen Qixin, Chen Gang, Li FangcaiAbstractThe aim of this study was to demonstrate the techniques of modified lateral lumbar interbody fusion and investigate its approach related complications. Fifty-two patients underwent with modified lateral lumbar interbody fusion (LLIF) in our center were studied retrospectively. There were 20 males and 32 females, aged from 45 to 82 years old (averaged at 66.0 ± 11.2). The diagnosis was as following: degenerative spinal scoliosis in 21 cases, lumbar spinal stenos...
Source: Journal of Clinical Neuroscience - Category: Neuroscience 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
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