Symptomatic tandem spinal stenosis: a clinical, diagnostic, and surgical challenge

In this study, we present a consecutive series of patients with symptomatic TSS and report diagnostic and surgical challenges. We retrospectively reviewed a consecutive series ofN = 8 patients with symptomatic TSS who underwent surgical treatment in at least one region of the spine. Patients presented with multiple complaints, including neurogenic claudication, progressive gait disturbances, and signs of radiculopathy and/or myelopathy, among others. Modified Japanese Orthopedic Association (mJOA) and Oswestry Low Back Pain Disability Questionnaire (ODI) were obtained in pre- and postoperative period. Electroneurophysiological examinations were limited to patients whose clinical and radiological signs were not sufficient to determine which region was more affected. From 2015 to 2018, we includedN = 8 consecutive patients with TSS who underwent surgery by a staged approach. The stenosis was localized in the cervical and lumbar region in six patients (75%) and in the cervical, dorsal, and lumbar level (triple TSS) in two patients (25%). Four patients (50%) underwent cervical and lumbar su rgery, two (25%) underwent cervical surgery alone, and two (25%) were operated in all three involved regions. Surgical treatment allowed an improvement of the mean mJOA score (from 12.5/17 to 15/17) and mean ODI score (from 41 to 28%). TSS represents a clinical, diagnostic, and surgical challenge. W e recommend to systematically obtain electrophysiological and radio...
Source: Neurosurgical Review - Category: Neurosurgery Source Type: research

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Conclusion. Although intent-to-treat analysis failed to show significant differences in patients treated surgically, results of the as-treated analysis determined statically greater improvements in those patients with spondylolisthesis who were treated surgically as compared to those treated nonoperatively. Level of Evidence: 2
Source: Spine - Category: Orthopaedics Tags: LITERATURE REVIEW 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
Authors: Park JW, Lee BJ, Jeon SR, Rhim SC, Park JH, Roh SW Abstract Discal cysts are a rare cause of low back pain and radiculopathy with unknown pathophysiologic mechanism. Associated symptoms are difficult to distinguish from those caused by extruded discs and other spinal canal lesions. Most discal cysts are treated surgically, but it is unclear whether the corresponding intervertebral disc should be excised along with cyst. We conducted a retrospective clinical review of 27 patients who underwent discal cyst excision at our institution between 2000 and 2017. The mean follow-up period was 63.6 months. We record...
Source: Neurologia Medico-Chirurgica - Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) 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
Authors: Enke O, New HA, New CH, Mathieson S, McLachlan AJ, Latimer J, Maher CG, Lin CC Abstract BACKGROUND: The use of anticonvulsants (e.g., gabapentin, pregabalin) to treat low back pain has increased substantially in recent years despite limited supporting evidence. We aimed to determine the efficacy and tolerability of anticonvulsants in the treatment of low back pain and lumbar radicular pain compared with placebo. METHODS: A search was conducted in 5 databases for studies comparing an anticonvulsant to placebo in patients with nonspecific low back pain, sciatica or neurogenic claudication of any duration...
Source: Canadian Medical Association Journal - Category: General Medicine Tags: CMAJ Source Type: research
Conclusion and discussion: The results of this study will provide clinical evidence on nonsurgical integrative interventions for patients with symptomatic lumbar spondylolisthesis. Clinical trial registry: clinicaltrials.gov (NCT03107468)
Source: Medicine - Category: Internal Medicine Tags: Research Article: Study Protocol Clinical Trial Source Type: research
ConclusionsIncreasing severity of SedSign indicates progressively smaller dural sac CSA, but there is an inconsistent association with clinical symptoms. Therefore, it is reasonable to suggest that spinal stenosis is severe in patients with severe symptoms.
Source: European Spine Journal - Category: Orthopaedics Source Type: research
CONCLUSIONS: The quality of the evidence examining physical activity and exercise for chronic pain is low. This is largely due to small sample sizes and potentially underpowered studies. A number of studies had adequately long interventions, but planned follow-up was limited to less than one year in all but six reviews.There were some favourable effects in reduction in pain severity and improved physical function, though these were mostly of small-to-moderate effect, and were not consistent across the reviews. There were variable effects for psychological function and quality of life.The available evidence suggests physica...
Source: Cochrane Database of Systematic Reviews - Category: Journals (General) Authors: Tags: Cochrane Database Syst Rev Source Type: research
Background: Trials of treatments for low back pain (LBP) generally exclude adults over 65 years of age. However, LBP has a significant impact on older people and there is a strong association bwetween LBP and immobility, disability, frailty and falls. Thus, there is a need to improve the management of LBP in older people through the generation and evaluation of new treatments. We have recently undertaken a programme of work with a focus on neurogenic claudication. This is a common spinal condition associated with older age.
Source: Manual Therapy - Category: Physiotherapy Authors: Source Type: research
CONCLUSIONS: The quality of the evidence examining physical activity and exercise for chronic pain is low. This is largely due to small sample sizes and potentially underpowered studies. A number of studies had adequately long interventions, but planned follow-up was limited to less than one year in all but six reviews.There were some favourable effects in reduction in pain severity and improved physical function, though these were mostly of small-to-moderate effect, and were not consistent across the reviews. There were variable effects for psychological function and quality of life.The available evidence suggests physica...
Source: Cochrane Database of Systematic Reviews - Category: Journals (General) Authors: Tags: Cochrane Database Syst Rev Source Type: research
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