Laminectomy

Garfin,; Glover, McKinley; Re, Booth; Fa, Simeone; Rh, Rothman

doi:10.1097/00002517-198801020-00003

Cited by 15 publications

(2 citation statements)

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“…Hence, the posterior decompression surgery was suggested for patients with leg predominant symptoms. [ 44 , 45 ] Our meta-analysis demonstrated that the leg pain had no significant difference between IPD treatment and alone decompression surgery at different time-points of follow-up (6, 12 mo and the last follow-up). We considered that patients in both groups received traditional decompression surgery, which effectively alleviated leg pain by nerve root decompression.…”

Section: Discussmentioning

confidence: 85%

Efficacy and safety of interspinous process device compared with alone decompression for lumbar spinal stenosis: A systematic review and meta-analysis

Zhu,

Xiao

2024

Medicine

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Study Design: Systematic review and meta-analysis. Background: Interspinous process devices (IPD) were used as a treatment in selected patients with lumbar spinal stenosis (LSS). However, the use of IPD was still debated that it had significantly higher reoperation rates compared to traditional decompression. Therefore, the purpose of the meta-analysis was to evaluate the effectiveness and safety of IPD treatment in comparison to traditional treatment. Methods: The databases were searched of PubMed, Embase and the Cochrane, Chinese National Knowledge Infrastructure, Chongqing VIP Database and Wan Fang Database up to January 2024. Relevant studies were identified by using specific eligibility criteria and data was extracted and analyzed based on primary and secondary endpoints. Results: A total of 13 studies were included (5 RCTs and 8 retrospective studies). There was no significant difference of Oswestey Disability Index (ODI) score in the last follow-up (MD = −3.81, 95% CI: −8.91–1.28, P = .14). There was significant difference of Visual Analog Scale (VAS) back pain scoring in the last follow-up (MD = −1.59, 95% CI: −3.09–−0.09, P = .04), but there existed no significant difference of leg pain in the last follow-up (MD = −2.35, 95% CI: −6.15–1.45, P = .23). What’s more, operation time, bleeding loss, total complications and reoperation rate had no significant difference. However, IPD had higher device problems (odds ratio [OR] = 9.00, 95% CI: 2.39–33.91, P = .001) and lesser dural tears (OR = 0.32, 95% CI: 0.15–0.67, P = .002) compared to traditional decompression. Conclusion: Although IPD had lower back pain score and lower dural tears compared with traditional decompression, current evidence indicated no superiority for patient-reported outcomes for IPD compared with alone decompression treatment. However, these findings needed to be verified in further by multicenter, double-blind and large sample RCTs.

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Section: Discussmentioning

confidence: 85%

Efficacy and safety of interspinous process device compared with alone decompression for lumbar spinal stenosis: A systematic review and meta-analysis

Zhu,

Xiao

2024

Medicine

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“…The most frequently performed procedure is posterior decompression, with the primary aim of relieving leg symptoms. Although LBP also often decreases after surgery, 1,2 decompression is generally thought to yield worse results for LBP than for leg pain and is suggested for patients with leg predominant symptoms 3 . However, some studies have reported similar improvements in pain scores between LBP and leg pain 4–7 .…”

mentioning

confidence: 99%

Relief of Low Back Pain After Posterior Decompression for Lumbar Spinal Stenosis

Kakiuchi

Wada

Harada

et al. 2021

Spine

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Study Design. A retrospective study.Objective. The aim of this study was to confirm that decompression for lumbar spinal stenosis (LSS) relieves low back pain (LBP) as adequately as it relieves leg pain and to identify predictors for inadequate LBP relief. Summary of Background Data. Although decompression for LSS is generally thought to yield worse results for LBP than for leg pain, some studies have reported similar improvements in pain scores between LBP and leg pain. To treat LBP or take measures to prevent inadequate LBP relief, reliable predictors for LBP relief should be identified. Methods. We retrospectively reviewed 175 patients who underwent posterior element-preserving decompression and evaluated the relief of LBP and leg pain using numeric rating scales (NRSs). Associations between demographic, clinical, or imaging parameters and LBP relief at 1 and 4 years were analyzed by stepwise linear regression analyses. The imaging parameters included Modic change type 1, disc degeneration, foraminal stenosis, vertebral slipping (within Grade 1), scoliosis (<158) and lordosis. Results. The mean improvements in LBP and leg pain NRS scores from baseline were 5.22 and 4.70 points (P ¼ 0.064, paired t test) at 1 year and 5.12 and 4.62 points (P ¼ 0.068) at 4 years, respectively. Poor LBP scores at 4 years were significantly associated with long-lasting LBP (beta ¼ 0.31, P < 0.0001) and moderate or severe arm symptoms with cervical spinal cord compression or intramedullary hyperintense signal on T2weighted MRI (beta ¼ 0.22, P ¼ 0.0014). The imaging parameters of the lumbar spine failed to show clear associations with poor LBP scores at 4 years, although Modic change type 1 showed a significant association with poor LBP scores at 1 year (beta ¼ 0.28, P < 0.0001). Conclusion.Posterior decompression relieves LBP as well as leg pain. Long-lasting LBP and concurrent symptomatic cervical myelopathy are important predictors for inadequate LBP relief. There were no reliable imaging parameters predictive of inadequate LBP relief. K e y w o r d s : a r m s y m p t o m , c e r v i c a l m y e l o p a t h y , decompression, disc degeneration, duration of LBP, foraminal stenosis, leg pain, low back pain, lumbar spinal stenosis, Modic change Type 1, numeric rating scale, predictor, spinous process-splitting approach, suspension laminoplasty.

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Surgical treatment of lumbar spinal stenosis: Patients' postoperative disability and working capacity

1994

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A total of 439 patients operated on for lumbar spinal stenosis during the period 1974-1987 was re-examinated and evaluated for working and functional capacity approximately 4 years after the decompressive surgery. The assessment of subjective disability was based on the Oswestry low-back pain questionnaire. The proportion of excellent-to-good outcomes was 62% (women 57%, men 65%). The ability to work before or after the operation and a history of no prior back surgery were variables predictive of a good outcome. Before the operation 86 patients were working, 223 patients were on sick leave, and 130 patients were retired. After the operation 52 of the employed patients and 70 of the unemployed patients returned to work. None of the retired patients returned to work. In logistic regression analysis the ability to work preoperatively, age under 50 years at the time of operation and the absence of prior back surgery predicted a postoperative ability to work. Our results suggest that more attention should be focussed on the diagnosis of spinal stenosis and on the timing of the operative intervention.

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Laminectomy

Cited by 15 publications

References 0 publications

Efficacy and safety of interspinous process device compared with alone decompression for lumbar spinal stenosis: A systematic review and meta-analysis

Efficacy and safety of interspinous process device compared with alone decompression for lumbar spinal stenosis: A systematic review and meta-analysis

Relief of Low Back Pain After Posterior Decompression for Lumbar Spinal Stenosis

Surgical treatment of lumbar spinal stenosis: Patients' postoperative disability and working capacity

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