Microdecompression for Lumbar Spinal Canal Stenosis

Weiner, Bradley K.; Walker, Matthew T.; Brower, Richard S.; McCulloch, John A.

doi:10.1097/00007632-199911010-00016

Cited by 180 publications

(132 citation statements)

References 8 publications

Supporting

Mentioning

124

Contrasting

Unclassified

Order By: Relevance

“…Kleeman et al (17) used such a technique and their overall results at 2.5 years post-operatively, according to modified meta-analysis criteria, were good to excellent in 84 % of the patients. In a study by Weiner et al (25) using microsurgical technique with preservation of the supra-/interspinous ligament complex and the contralateral musculature 43 % of the patients were very satisfied and another 43 % fairly satisfied. In another study by the same group (24), bilateral muscle retraction was used together with osteotomies of the spinal processes followed by laminotomies and "trumpeted" decompression without use of the microscope.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Microsurgical decompression without laminectomy in lumbar spinal stenosis

Nyström

Weber²,

Amundsen³

2001

Upsala Journal of Medical Sciences

View full text Add to dashboard Cite

Our objectives were to study a/ the clinical results of microsurgical decompression without laminectomy compared to those reported from standard decompression laminectomy in patients with central lumbar spinal stenosis, and b/ if the microsurgical technique could prevent post-operative instability and concomitant symptoms.Twenty-one patients were treated, 11 men and 10 women, aged 47-81 years. Fourteen patients had "pure" stenosis whereas 7 had additional diseases that compounded the symptoms of stenosis. Independent examiners saw the patients pre-operatively and a mean of 27 months post-operatively. Plain X-ray films were taken of 14 patients a mean of 5 years post-operatively to study possible slippage.Among the 14 patients with "pure" stenosis the results were excellent in 13 and fair in 1. Among the 7 with additional diseases the outcome was excellent in 1, fair in 1, unchanged in 3 and worse in 2. The technique did not prevent post-operative slippage, which occurred in 3 of 14 patients. However, the clinical outcome was not related to slippage.We found the microsurgical technique safe and gentle with excellent possibilities for decompression of the complete spinal canal without laminectomy. The results following this procedure were well comparable to or even better than those reported following standard decompression laminectomy.

show abstract

Section: Discussionmentioning

confidence: 99%

“…Some such techniques in which laminotomies are performed instead of laminectomies, have shown promising results (2). Although applied mostly in cases of lateral recess stenosis (4,5), laminotomy has recently been used to treat central stenosis as well (22,25).…”

Section: Introductionmentioning

confidence: 99%

Microsurgical decompression without laminectomy in lumbar spinal stenosis

Nyström

Weber²,

Amundsen³

2001

Upsala Journal of Medical Sciences

View full text Add to dashboard Cite

show abstract

“…Laminectomy is the standard option for surgical decompression of spinal stenosis. However, traditional laminectomy involves extensive removal of the posterior elements including the lamina, spinous processes, superspinous ligaments, interspinous ligaments, and even facet joints, which may result in iatrogenic spinal instability [16,17]. Foraminotomy has become increasingly popular for treatment of patients with lumbar stenosis.…”

Section: Introductionmentioning

confidence: 99%

Clinical outcomes following sublaminar-trimming laminoplasty for extensive lumbar canal stenosis

et al. 2013

View full text Add to dashboard Cite

Purpose Current surgical approaches for treatment of lumbar canal stenosis are often associated with relatively high rates of reoperation and recurrent stenosis. We have developed a new approach for treatment of this condition: sublaminar-trimming laminoplasty. To describe the surgical approach of sublaminar-trimming laminoplasty and to assess associated outcomes. Methods Patients with extensive lumbar canal stenosis who received sublaminar-trimming laminoplasty from 2006 to 2008 were considered for inclusion in the study. The surgery comprised aspects of laminotomy and laminectomy. The following were assessed before surgery and 3 years after surgery: leg and back pain by visual analog scale (VAS), extent of disability by Oswestry Disability Index (ODI), severity of back pain by Japanese Orthopedic Association Score for Back Pain (JOA), walking tolerance, and leg numbness. Complications were noted. Results A total of 49 patients were included in the study (mean age 65.6 ± 10.6 years). VAS leg and back pain, ODI, and JOA scores significantly changed from before surgery to 3 years after surgery (P \ 0.001). Mean changes (95 % confidence interval) were -6.2

show abstract

“…Preservation of the posterior spinal elements is the most important factor for successful decompression surgery of lumbar canal stenosis (LCS). Some authors have reported good clinical outcomes following microsurgical bilateral decompression via a unilateral approach (MBDU), a less invasive technique preserving the posterior elements, including the paravertebral muscle, facet joints, and lamina [1][2][3][4][5][6]. Some studies have also reported the clinical results of MBDU for LCS in mild instability cases, such as spondylolisthesis and complications from haemodialysis [7,8], but there are few reports examining complications after MBDU or risk factors that might preclude certain patients from MBDU.…”

Section: Introductionmentioning

confidence: 99%

Clinical characteristics of intraspinal facet cysts following microsurgical bilateral decompression via a unilateral approach for treatment of degenerative lumbar disease

et al. 2013

View full text Add to dashboard Cite

Purpose Primary intraspinal facet cysts in the lumbar spine are uncommon, but it is unclear whether cyst incidence increases following decompression surgery and if these cysts negatively impact clinical outcome. We examined the prevalence, clinical characteristics, and the risk factors associated with intraspinal facet cysts after microsurgical bilateral decompression via a unilateral approach (MBDU). Methods We studied 230 patients treated using MBDU for lumbar degenerative disease (133 men and 97 women; mean age 70.3 years). Clinical status, as assessed by the Japanese Orthopedic Association (JOA) score and findings on X-ray and magnetic resonance images, was evaluated prior to surgery and at both 3 months and 1 year after surgery. The prevalence of intraspinal facet cysts was determined and preoperative risk factors were defined by comparing presurgical findings with clinical outcomes. Results Thirty-eight patients (16.5 %) developed intraspinal facet cysts within 1 year postoperatively, and 24 exhibited cysts within 3 months. In 10 patients, the cysts resolved spontaneously 1 year postoperatively. In total, 28 patients (12.2 %) had facet cysts 1 year postoperatively. The mean JOA score of patients with cysts 1 year postoperatively was significantly lower than that of patients without cysts. This poor clinical outcome resulted from low back pain that was not improved by conservative treatment. Most cases with spontaneous cyst disappearance were symptom-free 1 year later. The preoperative risk factors for postoperative intraspinal facet cyst formation were instability (OR 2.47, P = 0.26), scoliotic disc wedging (OR 2.23, P = 0.048), and sagittal imbalance (OR 2.22, P = 0.045). Conclusions Postoperative intraspinal facet cyst formation is a common cause of poor clinical outcome in patients treated using MBDU.

show abstract

Microdecompression for Lumbar Spinal Canal Stenosis

Abstract: Lumbar microdecompression is a minimally invasive technique that appears to provide excellent functional outcomes.

Cited by 180 publications

References 8 publications

Microsurgical decompression without laminectomy in lumbar spinal stenosis

Microsurgical decompression without laminectomy in lumbar spinal stenosis

Clinical outcomes following sublaminar-trimming laminoplasty for extensive lumbar canal stenosis

Clinical characteristics of intraspinal facet cysts following microsurgical bilateral decompression via a unilateral approach for treatment of degenerative lumbar disease

Contact Info

Product

Resources

About