Clinical study of bilateral decompression via vertebral lamina fenestration for lumbar interbody fusion in the treatment of lower lumbar instability

Guo, Shuguang; Sun, Junying; Tang, Genlin

doi:10.3892/etm.2013.903

Cited by 11 publications

(19 citation statements)

References 27 publications

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“…In the past few decades, lumbar interbody fusion has been considered as the standard procedure for the treatment of LSS. Still, the surgical trauma was great, accomplished by the destruction of bone, increasing the risk of postoperative intervertebral instability (32). Compared with minimally invasive surgery, patients with traditional open surgery showed a longer time of lying in bed, and the incidence of complications was signi cantly higher, such as pulmonary infection, symptomatic deep venous thrombosis, urinary tract infection and so on (33,34).…”

Section: Discussionmentioning

confidence: 99%

WITHDRAWN: Treatment for Lumbar Spinal Stenosis Secondary to Ligamentum Flavum Hypertrophy Using Percutaneous Endoscopy through Interlaminar Approach: A Retrospective Study

Liu

Diaty

et al. 2020

Preprint

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Background: This paper is to describe percutaneous endoscopy in the treatment of lumbar spinal stenosis secondary to ligamentum flavum hypertrophy targeted. To investigate the efficacy and safety of percutaneous endoscopy in the treatment of this kind of lumbar spinal stenosis in elderly patients.Method: A retrospective analysis of 40 elderly patients with lumbar spinal stenosis secondary to ligamentum flavum hypertrophy admitted between January 2016 and January 2018 was performed. According to different surgical methods, they were divided into two groups: the control group and the endoscopy group (interlaminar approach), 20 people per group. There were 9 males and 11 females in the control group; the age of patients was 65.65±4.44years, and the average disease duration was 4.55±1.85 years. Besides, There were 10 males and 10 females in the endoscopy group; the age of patients was 67.30±4.23years, and the average disease duration was 4.95±2.04 years. Collect and count surgical-related indicators, preoperative and postoperative radiologic findings, incision visual analogue scale (VAS), lumbar and leg pain VAS, lumbar Japanese Orthopaedic Association (JOA) and Oswestry disability index (ODI) scores of all patients.Result: A series of surgical indicators (including the operation time, the quantity of bleeding and postoperative hospital stay) in the endoscopy group was significantly lower than that in the control group (p < 0.05). The incision VAS score in the endoscopy group was also significantly lower than that in the control group at each time after surgery (p < 0.05). Besides, compared with the control group, in the endoscopy group, the leg pain VAS score and lumbar ODI score after surgery were significantly decreased (p < 0.05). Compared with the control group, in the endoscopy group, the lumbar JOA score was significantly higher (p < 0.05).Conclusion: Percutaneous endoscopic technique is a small trauma, quick recovery, safe and effective minimally invasive surgery for patients with lumbar spinal stenosis secondary to ligamentum flavum hypertrophy.

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Section: Discussionmentioning

confidence: 99%

WITHDRAWN: Treatment for Lumbar Spinal Stenosis Secondary to Ligamentum Flavum Hypertrophy Using Percutaneous Endoscopy through Interlaminar Approach: A Retrospective Study

Liu

Diaty

et al. 2020

Preprint

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“…But only a limited amount of the posterolateral disc is accessible through the posterior approach and more facet excision would be necessary to access the lateral reaches of the foraminal canal. Excessive removal of the facet joints has been associated with destabilization of the spine (33,34). A 34.2% increase in the intervertebral foraminal area and a significant increase in extension and axial rotation flexibility were noted after the posterior decompression.…”

Section: Hds Suitable For Treatment With Modified Plfmentioning

confidence: 99%

Modified Percutaneous Lumbar Foraminoplasty and Percutaneous Endoscopic Lumbar Discectomy: Instrument Design, Technique Notes, and 5 Years Follow-up

2017

Pain Phys

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Background: Conventional percutaneous endoscopic lumbar discectomy (PELD) with an “insideoutside” technique has 4.3% – 10.3% surgical failure rate, especially in central herniated discs (HDs), migrated HDs, and axillary type HDs. PELD with foraminoplasty has been used for complex HDs. Percutaneous lumbar foraminoplasty (PLF), which is performed with a trephine or bone reamer introduced over a guidewire without a protective working cannula in the original Tessys technique, can quickly cut the hypertrophied bony structure under fluoroscopic guidance, and risk injury to the exiting and traversing nerve roots. Study Design: A prospective cohort study. Setting: Hospital and outpatient surgical center. Objective: To evaluate the outcome and safety of modified PLF-PELD with a specially designed instrument for complex uncontained lumbar HDs. Method: From April of 2007 to April of 2009, 148 patients with uncontained lumbar HDs were treated with modified PLF-PELD. Magnetic resonance imaging (MRI) checkup was performed the next morning after the operation. Outcomes of symptoms were evaluated by follow-up interviews at 3 months, 6 months, one year, and 5 years after surgery. Low back pain and leg pain were measured by visual analog scale (VAS) score (1 – 100). Functional outcomes were assessed by using the Oswestry Disability Index (ODI) and modified MacNab criteria. Result: Follow-up data were obtained from 134 cases, including 14 cases on L3-4, 78 cases on L4-5, and 42 cases on L5-S1. One hundred-eight cases were prolapse type, while 26 cases were sequestration type. Pre-operative symptoms and deficits included nerve root dermatome hypoesthesia in 98 patients (73%), nerve root myotome muscle weakness in 32 patients (23%), and weakening or disappearance of tendon reflex in 43 patients (32%). No case required conversion to an open procedure during the surgery. Low back pain and leg pain were significantly relieved immediately after surgery in all patients. MRI examination showed adequate removal of HD in all patients. VAS scores and ODI values were significantly lower at all time points after surgery than before surgery. The percentage of pain relief in leg pain was significantly higher than that in low back pain (P < 0.01). But there was no significant correlation between duration of the preoperative symptoms and the percentage of pain relief. MacNab scores at 5 years after surgery were obtained from 134 patients. Seventy-five cases were rated “excellent”; 49 were rated “good,” Five patients experienced heavier low back pain, thus being classified as “fair.” Five cases with recurrence were rated “poor.” Preoperative and postoperative (5 years follow-up) related nerve root function status was compared. Sensation and muscle strength recovered significantly (P < 0.01), while tendon reflex was not changed (P = 0.782). No patients had infections. Five patients were complicated with dysesthesia in distribution of the exiting nerve that was all operated at L5-S1. Complaints were reduced one week after treatment with medium frequency pulse electrotherapy. Five cases required a revision surgery after recurrence. Limitations: This is an observational clinical case series study without comparison. Cohort Study Modified Percutaneous Lumbar Foraminoplasty and Percutaneous Endoscopic Lumbar Discectomy: Instrument Design, Technique Notes, and 5 Years Follow-up From: The First Affiliated Hospital of Chinese PLA’s General Hospital Beijing, China Address Correspondence: Zhen-zhou Li, M.D. Associate Chief Surgeon The First Affiliated Hospital of Chinese PLA’s General Hospital, Department of Orthopedic Surgery No. 51, Fucheng Road Haidian district Beijing, Beijing 100048 China 86 1068989322 E-mail: dr_lizhenzhou@163.com Disclaimer: There was no external funding in the preparation of this manuscript. Conflict of interest: Each author certifies that he or she, or a member of his or her immediate family, has no commercial association (i.e., consultancies, stock ownership, equity interest, patent/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted manuscript. Manuscript received: 08-10-2015 Revised manuscript received: 12-28-2015 Accepted for publication: 03-28-2015 Free full manuscript: www.painphysicianjournal. com Zhen-zhou Li, MD, Shu-xun Hou, MD, Wei-lin Shang, MD, Ke-ran Song, MD, and Hong-liang Zhao, MD www.painphysicianjournal.com Pain Physician 2017; 20:E85-E98 • ISSN 2150-1149 Conclusion: Modified PLF-PELD with a specially designed instrument is a less invasive, effective and safe surgery for complex uncontained lumbar DH. Key words: Lumbar disc herniation, minimally invasive treatment, foraminoplasty, percutaneous endoscopic lumbar discectomy

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“…Standard laminectomy is the main step in PLIF for lumbar degenerative spondylolisthesis [15] where the whole lamina with the spinous process and inferior articular facets are removed.…”

Section: Introductionmentioning

confidence: 99%

Direct pedicle visualization and disc space orientation as the only guide for lumbar pedicular screw insertion

Salama¹

2018

Egypt J Neurosurg

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Background: Different methods for lumbar pedicular screw insertion have been advocated; however, each technique has its cons and pros. Limited resources for O-arm and navigation in our locality enforced us to use our surgical skills to minimize the need for such advanced modalities. The aim of the study is to clarify the benefits of the use of free-hand technique using direct visualization of the pedicles and disc space as the only guide for pedicular screw insertion using postoperative CT for evaluation of the accuracy of pedicle screw insertion. Patients and methods: One hundred forty-four screws were inserted in 32 patients using direct pedicle visualization and disc space orientation as a single intraoperative reference guide. The study was conducted in Zagazig University Hospitals from May, 2014, to June, 2015. CT was done for all patients as a direct postoperative evaluation tool. Results: There were 24 cases of single-level lumbar degenerative spondylolisthesis (96 screws) and eight with double-level degenerative spondylolisthesis DSL (48 screws). One hundred forty-four screws were inserted. Only three out of 144 screws were not purely intrapedicular; superior and lateral violations were not clinically significant. Conclusions: Direct pedicle visualization with the use of disc space orientation as a reference guide is a good alternative to the most advanced intraoperative monitoring techniques that are more readily available in developed countries.

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Clinical study of bilateral decompression via vertebral lamina fenestration for lumbar interbody fusion in the treatment of lower lumbar instability

Cited by 11 publications

References 27 publications

WITHDRAWN: Treatment for Lumbar Spinal Stenosis Secondary to Ligamentum Flavum Hypertrophy Using Percutaneous Endoscopy through Interlaminar Approach: A Retrospective Study

WITHDRAWN: Treatment for Lumbar Spinal Stenosis Secondary to Ligamentum Flavum Hypertrophy Using Percutaneous Endoscopy through Interlaminar Approach: A Retrospective Study

Modified Percutaneous Lumbar Foraminoplasty and Percutaneous Endoscopic Lumbar Discectomy: Instrument Design, Technique Notes, and 5 Years Follow-up

Direct pedicle visualization and disc space orientation as the only guide for lumbar pedicular screw insertion

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