Evaluation of Indirect Decompression of the Lumbar Spinal Canal Following Minimally Invasive Lateral Transpsoas Interbody Fusion: Radiographic and Outcome Analysis

医学 椎板切除术 外科 腰椎管狭窄症 脊椎滑脱 神经源性跛行 椎管狭窄 减压 腰椎 椎管 背痛 Oswestry残疾指数 脊柱融合术 腰痛 可视模拟标度 射线照相术 腰椎 脊髓 替代医学 病理 精神科
作者
Eric Elowitz,Daniel S. Yanni,Mark Chwajol,R Starke,Noel I. Perin
出处
期刊:Minimally Invasive Neurosurgery [Thieme Medical Publishers (Germany)]
卷期号:54 (05/06): 201-206 被引量:125
标识
DOI:10.1055/s-0031-1286334
摘要

The surgical treatment of lumbar stenosis traditionally includes laminectomy for direct decompression of the spinal canal. Selected patients with spinal stenosis may also require lumbar fusion. Minimally invasive lateral transpsoas interbody fusion has the ability of placing a large interbody cage that can increase disc height and distract the spinal level. The purpose of this study was to examine the concept of indirect decompression of the spinal canal in patients with co-existing lumbar spinal stenosis undergoing lateral transpsoas interbody fusion. We reviewed 25 consecutive spinal stenosis patients with instability undergoing lateral transpsoas interbody fusion without laminectomy. All patients had relevant symptoms of back pain, leg pain, and/or spinal claudication and met standard criteria for lumbar fusion. Patients were evaluated by outcome analysis scales (VAS scores, Oswestry disability index and treatment intensity scale). Postoperative MRI scans, when available, were evaluated for change in canal dimensions. Statistical significance was assessed by paired t-test, which compares the mean change. There were 25 patients in the study (mean age 61 years). 15 patients had grade I spondylolisthesis. VAS for back pain intensity improved from 7.74 to 2.07 and for frequency from 7.91 to 2.22. VAS for leg pain intensity improved from 7.24 to 1.87 and frequency from 7.41 to 2.35. All improvements were statistically significant (P<0.0001). The Oswestry disability index improved from 55.1 to 16.4 (P<0.0001), and treatment intensity scale improved from 14.6 to 3.7 (P<0.0001). Radiographic evaluation in 20 treated levels (15 patients) found an increase in dural sac dimension of 54% in the anterior-posterior plane and 48% in the medial-lateral plane (P<0.0001). The calculated area of the dural sac increased an average of 143% (range of − 10.4% to + 495%). Indirect decompression of spinal stenosis can be achieved with lateral transpsoas interbody fusion with improved clinical outcomes. Pre-op and post-op MRI scans showed a significant increase in dural sac dimensions. The mechanism for this indirect decompression may relate to stretching and unbuckling of the spinal ligaments and a decrease in intervertebral disc bulging. Further studies are needed to determine which stenosis patients undergoing this surgery are most appropriate for indirect decompression alone over laminectomy.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
充电宝应助科研通管家采纳,获得10
刚刚
1秒前
姚怜南完成签到,获得积分10
3秒前
青珊完成签到,获得积分10
5秒前
自觉石头完成签到 ,获得积分10
6秒前
VVTTWW完成签到 ,获得积分10
8秒前
感性的寄真完成签到 ,获得积分10
10秒前
zhang完成签到,获得积分10
13秒前
16秒前
比比谁的速度快应助zhang采纳,获得50
20秒前
绿袖子完成签到,获得积分10
22秒前
29秒前
刘刘完成签到 ,获得积分10
30秒前
执着夏岚完成签到 ,获得积分10
30秒前
Xzx1995完成签到 ,获得积分10
34秒前
Hululu完成签到 ,获得积分10
36秒前
淡然的芷荷完成签到 ,获得积分10
37秒前
GT完成签到,获得积分10
39秒前
qiancib202完成签到,获得积分10
42秒前
量子星尘发布了新的文献求助10
43秒前
等待的幼晴完成签到,获得积分10
44秒前
负责灵萱完成签到 ,获得积分10
46秒前
幽默的忆霜完成签到 ,获得积分10
54秒前
56秒前
1分钟前
风光无限完成签到 ,获得积分20
1分钟前
庄海棠完成签到 ,获得积分10
1分钟前
量子星尘发布了新的文献求助10
1分钟前
沐风完成签到 ,获得积分10
1分钟前
含糊的茹妖完成签到 ,获得积分0
1分钟前
1分钟前
huangqian完成签到,获得积分10
1分钟前
沧海一粟完成签到 ,获得积分10
1分钟前
进击的巨人完成签到 ,获得积分10
1分钟前
1分钟前
牛马完成签到,获得积分10
1分钟前
1分钟前
我不是奶黄包完成签到,获得积分10
1分钟前
Gavin完成签到,获得积分10
1分钟前
cq_2完成签到,获得积分10
1分钟前
高分求助中
【提示信息,请勿应助】关于scihub 10000
Les Mantodea de Guyane: Insecta, Polyneoptera [The Mantids of French Guiana] 3000
徐淮辽南地区新元古代叠层石及生物地层 3000
The Mother of All Tableaux: Order, Equivalence, and Geometry in the Large-scale Structure of Optimality Theory 3000
Handbook of Industrial Diamonds.Vol2 1100
Global Eyelash Assessment scale (GEA) 1000
Picture Books with Same-sex Parented Families: Unintentional Censorship 550
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 4038029
求助须知:如何正确求助?哪些是违规求助? 3575740
关于积分的说明 11373751
捐赠科研通 3305559
什么是DOI,文献DOI怎么找? 1819224
邀请新用户注册赠送积分活动 892652
科研通“疑难数据库(出版商)”最低求助积分说明 815022