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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An open decompression is the most common treatment for lumbar spinal canal stenosis (LSS), even in the elderly. However, it is not clear whether the treatment outcome is age dependent. The main purpose of this study was to evaluate the improvement in quality of life (QoL) and pain relief, after open decompression for LSS in relation to patient age. ⋯ Our results confirm that all age groups significantly benefit from the open decompressive treatment of LSS. Age group had no significant influence on any outcome.
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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.
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Patient satisfaction is an outcome measure for low-back pain (LBP) interventions which allows clinicians to design patient-oriented treatments. The Treatment Outcome Satisfaction Questionnaire (TOSQ) is an English instrument constructed for such evaluations, and no equivalent instruments exist for the Swedish population. This study, therefore, translated TOSQ into Swedish and assessed the translated version's psychometric properties for patients with LBP. ⋯ A six-item TOSQ-S configuration showed acceptable psychometric properties and is suitable for measuring treatment outcome satisfaction of physiotherapy in patients with LBP.
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Tubular laminotomy is an effective procedure for treatment of lumbar spinal stenosis (LSS) and lateral recesses stenosis. Most surgeons familiar with the procedure agree that the tubular approach appears to afford a more complete decompression of the contralateral thecal sac and nerve root, as compared to the ipsilateral approach. With this study we sought to answer the question whether this is reflected in clinically significant differences between the ipsilateral and contralateral side pain improvements. ⋯ MIS tubular laminotomy through a unilateral approach results in clinically effective bilateral decompression of LSS and lateral recesses, regardless of the approach side.
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Dynamic trunk flexion-extension testing has been proven to objectively diagnose low back pain in persons under the age of 60 years but older persons have difficulty complying with standardized movement velocity. ⋯ Lumbar extensor muscle activity demonstrated moderate to good diagnostic value in old patients.