European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
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Multicenter Study
Degenerative lumbar spinal canal stenosis: intra- and inter-reader agreement for magnetic resonance imaging parameters.
To assess the inter- and intra-reader agreement of commonly used quantitative and qualitative image parameters for the assessment of degenerative lumbar spinal canal stenosis (LSS) by magnetic resonance imaging (MRI). ⋯ The inter- and intra-reader agreement of commonly used quantitative and qualitative image parameters for the assessment of LSS showed quite a variability with previously defined core parameters having good to excellent inter- and intra-reader agreements.
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To compare MRI-defined back muscle volume between AS patients and age, and spinopelvic alignment matched control patients with chronic back pain. ⋯ AS patients without deformity already have decreased paraspinal muscle volume compared with age and spinopelvic alignment matched non-AS patients with chronic back pain. Such decrease in paraspinal muscle volume was significantly associated with kyphotic deformity of AS patients even after multivariate adjustment. Although the result of our study supports the causal relationship between muscle degeneration and kyphotic deformity in AS patients, further study is required to prove the causality.
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To report the techniques and safety of one-staged combined decompression for the patients with tandem spinal stenosis (TSS) at cervical and thoracic spine. ⋯ Combined cervico-thoracic decompression could provide fair neurological outcomes for patients with cervico-thoracic TSS, but it was complicated with high rate of undesirable postoperative events. So, more efforts should be done against its eventful postoperative course before its wide application.
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Comparative Study Observational Study
The effectiveness of decompression alone compared with additional fusion for lumbar spinal stenosis with degenerative spondylolisthesis: a pragmatic comparative non-inferiority observational study from the Norwegian Registry for Spine Surgery.
To evaluate the effect of adding fusion to decompression in patients operated for lumbar spinal stenosis with a concomitant lumbar degenerative spondylolisthesis. ⋯ In the present non-inferiority study, we cannot conclude that decompression alone is as good as decompression with additional fusion. However, the small differences in the groups' effect sizes suggest that a considerable number of patients can be treated with decompression alone. A challenge in future studies will be to find the best treatment option for each patient.
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Compared to the ligamentum flavum (LF), morphology of the epidural membrane (EM) and the periradicular fibrous tissue (PRFT) has been largely ignored in studies of lumbar spinal stenosis (LSS). The aim of this prospective study was to elucidate the morphologies and clinical importance of the EM and PRFT in LSS. ⋯ Some EM and PRFT transform into degenerative and substantial fibrous tissues during the process of symptomatic LSS development. Such morphological and histological changes can cause dural tear, symptomatic epidural hematoma, and/or inadequate decompression.