Degenerative Lumbar Spinal Stenosis in Older People

Kalff, Rolf; Ewald, Christian; Waschke, Albrecht; Gobisch, Lars; Hopf, C.

doi:10.3238/arztebl.2013.0613

Cited by 81 publications

(93 citation statements)

References 38 publications

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“…It is notable that there was no respiratory complication, which is one of the most common causes of morbidity and mortality in high-risk surgical patients. SA has been associated with complications such as hypotension, and bradycardia in previous studies (3,10,11). However in our study, no morbidity attributable to the anesthetic technique occurred.…”

Section: Discussionmentioning

confidence: 88%

“…Neurosurgeons and spine surgeons are now increasingly confronted with degenerative changes of the lumbar spine because of the aging population (10,19). Degenerative changes of the lumbar spine that are diagnosed by computed tomography and magnetic resonance imaging become more common with age and are present in all patients over 60 years old (10).…”

Section: Discussionmentioning

confidence: 99%

“…However, a significant number of patients who present a high surgical risk have undergone posterior lumbar stabilization surgery with GA (12,14). SA is not routinely used for posterior lumbar stabilization surgery, even for high-risk patients, despite the fact that degenerative spondylolisthesis, spinal stenosis and lumbar compression fractures often implies the patient population is elderly with pre-existing comorbidities (7,8,10,17,18).…”

Section: Introductionmentioning

confidence: 99%

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Posterior lumbar stabilization surgery under spinal anaesthesia for patients with degenerative spondylolisthesis, spinal stenosis and lumbar compression fracture

Erbaş

Pusat²,

Yı́lmaz³

et al. 2015

Turkish Neurosurgery

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AIm:Spinal anesthesia is an appropriate technique for lumbar spine surgeries of two to three hours duration. The aim of this study is to document our experience on spinal anesthesia administered to the patients with degenerative lumbar spine. mAterIAl and methOds: A total of 497 patients underwent spinal stabilization surgery with spinal anesthesia for degenerative lumbar spinal disorders in an 8-year period. Spinal anesthesia was performed at the L3-L4 or L4-L5 level and subarachnoid block was achieved with 15 mg of 0.5% plain bupivacaine with 2 µg of fentanyl and 0.2 mg of epinephrine. There was no failure of anesthesia. The patients were closely monitored for complications associated with the SA technique and especially hypotension and bradycardia but no gross alterations in cardiovascular stability were noted. results: Among the 497 patients, 139 were male and 358 were female with a median age of 51 years. The average anesthesia duration was 130 minutes and the average operative time was 85 minutes. In the postoperative period 36 patients has nausea (7.2%) and 18 of them had vomiting (3.6%) that required one dose of antiemetic. No spinal headache was observed and 36 (7.2%) patients complained of urinary retention. All recovered with urinary cannulation within 24 hours. No respiratory complication occurred and no patient died.COnClusIOn: Spinal anesthesia is a safe and effective procedure for the lumbar spinal stabilization surgery, especially in high-riskpatients. Proper precautions should be taken in order to achieve an effective anesthesia for these operations. BulGulAr: Toplam 497 hastanın 139 tanesi erkek, 358 tanesi ise bayandı ve ortalama yaş 51 idi. Ortalama anestezi süresi 130 dakika ve ortalama ameliyat süresi ise 85 dakika olarak hesaplandı. Postoperatif dönemde 36 (%7,2) hastada bulantı oldu ve bunların 18 (%3,6) tanesinde kusma görüldü. Bir doz antiemetik ile düzeldi. Spinal anesteziye bağlı başağrısı hiçbir hastada görülmedi ancak 36 (%7,2) hastada üriner retansiyon görüldü ve bu da 24 saat içinde üriner kanülasyon ile düzeldi. Solunum sıkıntısı görülmedi ve hiçbir hasta ölmedi. sOnuÇ: Spinal anestezi özellikle yüksek riskli hasta grubunda lomber stabilizasyon cerrahisi için güvenli ve etkili bir yöntemdir. Bu tür ameliyatlarda etkin anestezinin sağlanması için uygun tedbirlerin alınması gereklidir.

show abstract

Section: Discussionmentioning

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Posterior lumbar stabilization surgery under spinal anaesthesia for patients with degenerative spondylolisthesis, spinal stenosis and lumbar compression fracture

Erbaş

Pusat²,

Yı́lmaz³

et al. 2015

Turkish Neurosurgery

View full text Add to dashboard Cite

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“…Lumbar MRI was the standard procedure for the demonstration of stenosis [19]. In the present study, a total 30 subjects with mean age (in years) 38.53 ± 8.37 were participated in the study in which 10 were females and 20 were males.…”

Section: Discussionmentioning

confidence: 99%

Effect of Integrated Exercise Protocol in Lumbar Spinal Stenosis as Compare with Conventional Physiotherapy- A Randomized Control Trial

Kumar¹,

Narkeesh²

2017

Int J Neurorehabilitation Eng

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Background context: Lumbar Spinal Stenosis (LSS) is one of the most common spinal pathologies in India. Spinal stenosis is narrowing of the spinal canal with encroachment on the neural structures by surrounding bone and soft tissue. While it is widely held that conservative management should be the first line of approach in patients with LSS, little is known about the efficacy of non-surgical treatments for this condition.

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“…And because it presents this great functional structured composition, it is subjected to several forms of compromise, which can lead to permanent or temporary 1 functional restriction. Out of the most common conditions that lead to functional spinal restriction, there are: vertebral, rib, scapular and pelvic waste fractures, degenerative diseases, scoliosis, besides other forms of compromise that range in causal mechanisms and complexity and corroborate the restriction and consequent disuse or hypoactivity [2][3][4] . Concerning static and dynamic spinal stability, this system is inherently stable, which requires an active muscle support for postural maintenance and changes 3,5 .…”

Section: Introductionmentioning

confidence: 99%

Disuse induced by the spine rectification vest: experimental study

Guirro¹,

Arruda

Silva

2014

Fisioter. Pesqui.

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The spine is the main support and movement axis of the locomotor system, and numberless clinical conditions may require that this structure be submitted to functional restriction. Among the non-invasive treatments used in spinal or appendicular skeleton injuries, the immobilization of the spine is used as a rehabilitation strategy. Because of the functional restrictions generated by restraining devices used on the spine, the proposal of this study was to adapt a spinal orthosis on rats, thus mimicking the immobilization of corrective vests and assessing the energetic conditions of thoracic muscles after 12 weeks of application. Wistar rats that were 42 days old were used in this study (post-weaning period), followed-up for 12 weeks in 2 groups called control (C) and rectification vests (R), which were made of PVC to immobilize the spine. The following concentrations were evaluated: glycogen (GLY) of the paravertebral muscle and the thorax; total proteins and DNA (TP/DNA) and interleukin-6 (IL-6). The normality Kolmogorov-Smirnov test was used for statistical analysis, followed by the Tukey test. A 5% level was established for all of the calculations. It was observed that group R presented 12% less body mass and GLY stores 21% lower; the ratio between TP/DNA was in average 6.6% lower; IL-6 concentrations were in average 25% higher. The study shows that the movement restriction in the spine leads to energetic crisis and compromised muscular development. More studies should be conducted with this model to generate physical therapy strategies that could reduce muscle compromise after spine immobilization.

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Degenerative Lumbar Spinal Stenosis in Older People

Abstract: No evidence-based recommendation on the diagnosis and treatment of lumbar spinal stenosis in older people can be formulated at present because of the lack of pertinent randomized trials.

Cited by 81 publications

References 38 publications

Posterior lumbar stabilization surgery under spinal anaesthesia for patients with degenerative spondylolisthesis, spinal stenosis and lumbar compression fracture

Posterior lumbar stabilization surgery under spinal anaesthesia for patients with degenerative spondylolisthesis, spinal stenosis and lumbar compression fracture

Effect of Integrated Exercise Protocol in Lumbar Spinal Stenosis as Compare with Conventional Physiotherapy- A Randomized Control Trial

Disuse induced by the spine rectification vest: experimental study

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