Minimally Invasive Operative Management for Lumbar Spinal Stenosis: Overview of Early and Long-Term Outcomes

Asgarzadie, Farbod; Khoo, Larry T.

doi:10.1016/j.ocl.2007.02.006

Cited by 95 publications

(54 citation statements)

References 23 publications

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“…36 The minimally invasive nature of MEDL for LCS goes hand in hand with lower EBL (estimated blood loss), and shorter days of hospitalization compared to open laminectomy. 43 In our study, on level analysis, the mean intra-procedural EBL was 18.6 ml which is less than presented in the literature ranging between 25 and 150 ml yielded by Asgarzadie and Khoo 5 2007 and Xu et al, 56 2009 respectively. In accordance but slightly less with most of MEDL currently reported studies 7,58 the mean hospitalization days following the procedure was 1.4 days however it was more than that presented by Rahman et al, 41 2005 with mean days of 0.75.…”

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confidence: 58%

Microendoscopic bilateral Decompression via Unilateral Approach in Single and Multiple Level Lumbar Canal Stenosis: A Series of 583 Cases

Kabil

Ebrahim

2017

Egyptian Spine Journal

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Background Data: Traditionally, lumbar canal stenosis (LCS) has been treated with conventional laminectomy involving wide resection of posterior supporting structures of the lumbar spine such as the supraspinous and inter-spinous ligamentum complex, the spinous process as well as wide areas of the lamina. In addition, this required a large incision of the skin and underlying musculoligamentous complex (posterior tension band). Purpose: The current study focuses on the clinical outcome and utility of minimally invasive microendoscopic decompression from a unilateral approach in surgical management of patients with single and multiple level lumbar canal stenosis. The objective is to describe the indications, significance and applications of endoscopic spine surgery in patients with single and multiple level LCS. Additionally, to highlight important anatomical perspectives of the technique and share surgical experience and results. Study Design: A retrospective clinical case study. Patients and Methods: From May 2008 to January 2016, 583 consecutive patients were treated for LCS and included in this study. Patients' main complaint was bilateral neurogenic claudication in addition to back pain and sciatic neuralgia. Single level decompression was performed in 468 (80%) patients and multiple level decompressions in 115 (20%) patients. Magnetic resonance imaging (MRI), computed tomography (CT) scan and plain X-rays were performed for all patients to confirm evidence of central stenosis and then repeated postoperatively. All patients were followed up for at least 3 months and their data collected. Clinical and functional outcomes were assessed using Visual Analogue Scale (VAS) and the Japanese Orthopedic Association Score (JOA) score for lumbar disease. Results: Compared to preoperative complaint, there was an improvement of back pain in 77.9% of patients and in radiating leg pain in 86.3%. With regards to functional outcomes, median preoperative JOA score was 14.93 ± 0.48 and improved postoperatively to 27.17 ± 1.45 (p < 0.001). The mean operating time per level was 78 minutes, and the mean intraoperative blood loss per level was 18 ml. Complications mainly included dural tears in 27 (4.6%) patients, transient postoperative dysesthesia in 46/583 (7.9%) patients and excess bony work in the form of unintended medial facetectomy in 38/583 (6.5%) patients and fracture of the spinous process in 3 (0.5%) patients.

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confidence: 58%

Microendoscopic bilateral Decompression via Unilateral Approach in Single and Multiple Level Lumbar Canal Stenosis: A Series of 583 Cases

Kabil

Ebrahim

2017

Egyptian Spine Journal

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“…7 The conventional surgical treatment for LSS, open spine decompression, is considered to be invasive so less destructive surgical treatments are being sought. 8 To fulfill this need, outpatient minimally invasive spine surgery (MISS) has advanced and gained popularity. 8 Studies indicate that MISS is successful at providing satisfactory decompression for the treatment of LSS as open surgery without the larger incisions, or damage to the posterior ligamentum, muscles, and tissues.…”

mentioning

confidence: 99%

“…8 To fulfill this need, outpatient minimally invasive spine surgery (MISS) has advanced and gained popularity. 8 Studies indicate that MISS is successful at providing satisfactory decompression for the treatment of LSS as open surgery without the larger incisions, or damage to the posterior ligamentum, muscles, and tissues. 8e10 This is significant because the extensive surgical dissection and muscle detachment can cause weakness and has led, at times, to paraspinal muscle denervation and atrophy; which is linked to an increased prevalence of "failed back surgery syndrome" and chronic pain.…”

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confidence: 99%

Outpatient minimally invasive spine surgery using endoscopy for the treatment of lumbar spinal stenosis among obese patients

Hudak

Perry

2015

Journal of Orthopaedics

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“…2 Furthermore, LSS continues to increase in prevalence and is one of the most common reasons for surgery in elderly patients (>65 years old). [3][4][5][6] The cost to society in the United States resulting from this disease process has been estimated in the tens of billions of dollars annually. 7,8 The initial treatment of LSS consists of various nonoperative approaches including physical therapy, pain medications (NSAIDs, mild opioids), and epidural steroid injections, referred to as conservative care (CC) in this study.…”

Section: Introductionmentioning

confidence: 99%

Cost-effectiveness of three treatment strategies for lumbar spinal stenosis: Conservative care, laminectomy, and the Superion interspinous spacer

et al. 2015

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BackgroundLumbar spinal stenosis is a painful and debilitating condition resulting in healthcare costs totaling tens of billions of dollars annually. Initial treatment consists of conservative care modalities such as physical therapy, NSAIDs, opioids, and steroid injections. Patients refractory to these therapies can undergo decompressive surgery, which has good long-term efficacy but is more traumatic and can be associated with high post-operative adverse event (AE) rates. Interspinous spacers have been developed to offer a less-invasive alternative. The objective of this study was to compare the costs and quality adjusted life years (QALYs) gained of conservative care (CC) and decompressive surgery (DS) to a new minimally-invasive interspinous spacer.

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Minimally Invasive Operative Management for Lumbar Spinal Stenosis: Overview of Early and Long-Term Outcomes

Cited by 95 publications

References 23 publications

Microendoscopic bilateral Decompression via Unilateral Approach in Single and Multiple Level Lumbar Canal Stenosis: A Series of 583 Cases

Microendoscopic bilateral Decompression via Unilateral Approach in Single and Multiple Level Lumbar Canal Stenosis: A Series of 583 Cases

Outpatient minimally invasive spine surgery using endoscopy for the treatment of lumbar spinal stenosis among obese patients

Cost-effectiveness of three treatment strategies for lumbar spinal stenosis: Conservative care, laminectomy, and the Superion interspinous spacer

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