The role of triangular vertebral canal shape in surgical management of patients with lumbar spinal stenosis: a cross-sectional study

Bozkurt, Hüseyin; Kaya, İsmail; Öztoprak, Bilge

doi:10.5137/1019-5149.jtn.21108-17.4

Cited by 5 publications

(5 citation statements)

References 17 publications

(20 reference statements)

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“… 25 Finally, the spinal canal changes shape from ovoid to triangular as one moves caudally 6 ; the latter could be less ideal in the setting of LDH, where the nucleus pulposus typically extrudes from the relatively weaker posterolateral portion of the disc. 26 Bozkurt et al 6 found that postoperatively, patients with a triangular-shaped canal experienced higher satisfaction and a decrease in visual analogue pain scale after surgical decompression relative to more ovoid shaped canals. This finding may be indicative of the greater severity of symptoms in triangular canals relative to ovoid ones prior to surgery.…”

Section: Discussionmentioning

confidence: 99%

“…Cranially, the discs are relatively smaller and the spinal canal is more ovoid in shape; as one moves caudally, the spinal canal takes on a more triangular shape and load bearing is increased. 6 Some studies have noted a higher rate of degenerative disc disease in the more caudal regions resulting in an increased possibility for lumbar stenosis, among other pathologies. 7 This may have an impact on the rate of resolution of symptoms following a lumbar disc herniation, and in turn, may also affect the likelihood of successful non-operative treatment, where symptoms resolve without the need for surgery.…”

Section: Introductionmentioning

confidence: 99%

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Caudal Lumbar Disc Herniations Are More Likely to Require Surgery for Symptom Resolution

Gupta

Upadhyaya

Yeung

et al. 2020

Global Spine Journal

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Study Design: Retrospective study. Objectives: We examined the impact that location of a lumbar disc herniation has on the likelihood that a patient will require surgery after at least 6 weeks of nonoperative management. Methods: Using ICD-10 codes M51.26 and M51.27, we identified patients at a single academic institution from 2015 to 2016 who received a diagnosis of primary lumbar radicular pain, had magnetic resonance imaging confirming a lumbar disc herniation, and underwent at least 6 weeks of nonoperative management. Patients experiencing symptoms suggesting cauda equina syndrome or progressive motor deficits were excluded. Results: Five hundred patients met inclusion/exclusion criteria. Twenty-nine (5.8%) had L3-L4 herniations, 245 (49.0%) had L4-L5 herniations, and 226 (45.2%) had L5-S1 herniations. Overall, 451 (90.2%) patients did not undergo surgery within 1 year of diagnosis. Nonsurgical patients had an average herniation size occupying 31.2% of the canal, compared with 31.5% in patients who underwent surgery. While herniation size, age, sex, and race failed to demonstrate a statistical association with the likelihood for surgery, location of disc herniation demonstrated a strong association. L3-L4 and L4-L5 herniations had odds ratios of 0.19 and 0.45, respectively, relative to L5-S1 herniations ( P = .0047). Patients were more than twice as likely to require a surgery on an L5-S1 herniation in comparison with an L4-L5 herniation ( P < .05). L3-L4 herniations rarely required surgery. Conclusions: Patients with caudal lumbar disc herniations were more likely to require surgery after at least 6 weeks of conservative management than those with disc herniations in the mid-lumbar spine.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Caudal Lumbar Disc Herniations Are More Likely to Require Surgery for Symptom Resolution

Gupta

Upadhyaya

Yeung

et al. 2020

Global Spine Journal

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“…3) Trefoil shaped (7,14,21) Each channel shape is associated with its spinal shape and configuration ( Figure 1A-C). When we examined the spinal canal structures, the spinal canal was narrowed in the trefoilshaped canal.…”

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confidence: 99%

The relationship between transpedicular stabilization and the shape of the spinal canal

Kaya¹,

Bozkurt²

2020

Turkish Neurosurgery

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AIM: To analyze the spinal canal type and spinal structure of patients, to determine appropriate preoperative preparation and surgical procedures to prevent material malposition, which is the most common complication of thoracolumbar posterior transpedicular stabilization (TPTS) and is a determiner of its clinical outcomes. MATERIAL and METHODS: A total of 214 cases were examined. TPTS procedures carried out on each thoracolumbar vertebra were evaluated. Twenty parameters were documented and retrospectively examined in each patient. RESULTS: Laminectomy is not helpful for healing unless there is spinal compression and ligamentotaxis is beneficial for healing. The correlation between the structure of the spinal canal and defective screw delivery found (p<0.05). CONCLUSION: The spinal structure formed around the canal should be the first form to evaluate while TPTS applications to protect the spinal cord, which is the focal point of the spinal structure.

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“…The lumbar spine is inherently unstable, and its stability depends on the integrated function of active, passive, and neural subsystems [1]. Degenerative lumbar spinal stenosis (DLSS) is an age-related chronic disease [2,3]. It progresses with the degradation of 3 joint complexes and ligamentum flavum hypertrophy [2,4].…”

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confidence: 99%

“…Degenerative lumbar spinal stenosis (DLSS) is an age-related chronic disease [2,3]. It progresses with the degradation of 3 joint complexes and ligamentum flavum hypertrophy [2,4]. Spinal instability plays an important role in DLSS [5].…”

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confidence: 99%

Importance of paravertebral muscle quality in the etiology of degenerative lumbar spinal stenosis

Kaya

2023

The European Research Journal

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Objectives: Degenerative lumbar spinal stenosis (DLSS) is the leading cause of pain, disability, and loss of independence in older adults. In this study, the relationship between DLSS and paravertebral muscle thickness and density was investigated using computed tomography (CT) and magnetic resonance imaging (MRI) methods. Thus, the importance of muscles has been examined to take precautions in the name of preventive medicine. Methods: This study was planned as a cross-sectional study. The patient group (n = 77) who had surgery for DLSS and the control group (n = 77) were examined. A total of 154 participants (55 females and 22 males in each group) were evaluated retrospectively in terms of cross-sectional area (CSA) and density in the psoas, erector spina and multifidus muscles. In both groups age, gender and body mass index values equalized. Measurements was averaged from the mid-lumbar 3 level from both sides and multi-points. Results: There was no significant difference between muscle thicknesses (p > 0.05). When evaluated in terms of muscle densities, a significant difference was found between the patient and the control group in terms of psoas muscle (p < 0.05). Likewise, there is the same relationship between erector spinae muscle density and multifidus muscle density (p < 0.05). Conclusions: Roughly no difference was found between the patient and control groups in terms of CSA of the psoas, erector spinae and multifidus muscles, but it was observed that the muscle density, especially in the multifidus, decreased significantly in the patients. Our results suggest that paravertebral muscle density assessment is an important criterion in disease prediction and can inform preventive treatment.

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The role of triangular vertebral canal shape in surgical management of patients with lumbar spinal stenosis: a cross-sectional study

Cited by 5 publications

References 17 publications

Caudal Lumbar Disc Herniations Are More Likely to Require Surgery for Symptom Resolution

Caudal Lumbar Disc Herniations Are More Likely to Require Surgery for Symptom Resolution

The relationship between transpedicular stabilization and the shape of the spinal canal

Importance of paravertebral muscle quality in the etiology of degenerative lumbar spinal stenosis

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