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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Randomized Controlled Trial Multicenter Study
Comparable increases in dural sac area after three different posterior decompression techniques for lumbar spinal stenosis: radiological results from a randomized controlled trial in the NORDSTEN study.
To investigate changes in dural sac area after three different posterior decompression techniques in patients undergoing surgery for lumbar spinal stenosis. Decompression of the nerve roots is the main surgical treatment for lumbar spinal stenosis. The aim of this study was to radiologically investigate three commonly used posterior decompression techniques. ⋯ The study is registered at ClinicalTrials.gov reference on November 22th 2013 under the identifier NCT02007083.
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Review Meta Analysis
Clinical outcomes of lumbar spinal surgery in patients 80 years or older with lumbar stenosis or spondylolisthesis: a systematic review and meta-analysis.
This systematic review and meta-analysis of all available evidence was performed to assess the safety and efficacy of surgery for lumbar stenosis and spondylolisthesis in patients 80 years or older versus those younger than 80 years. ⋯ Our results revealed that the clinical improvement in pain and disability did not significantly differ according to age, although the patients aged 80 years or older had increased incidences of mortality and complication than younger patients. Age alone is not a contraindication for lumbar surgery in very old patients. A careful preoperative evaluation, proper patient selection and appropriate surgical approach are important to achieve successful surgical outcomes. These slides can be retrieved under Electronic Supplementary Material.
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Spinal epidural lipomatosis (SEL) is defined as an abnormal and extensive accumulation of unencapsulated adipose tissue within the spinal epidural space. To date, there is a lack of high-level evidence studies reporting the outcome of surgical treatment of symptomatic SEL in patients with lumbar spinal stenosis (LSS). The aim was to compare clinical outcomes in patients with symptomatic LSS with and without SEL who underwent decompression surgery alone at the 12- and 24-month follow-up. ⋯ Our study demonstrated that decompression alone surgery was associated with significant improvement in disability in both groups at 2 years, but not in pain and quality of life in patients with SEL.
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There is controversy regarding age-related deterioration of spinal sagittal alignment in cross-sectional study. Although we reported that deterioration in spinal alignment originated at the cervical spine in males and the pelvis in females, others studies have indicated that the lumbar spine is initially implicated in both sexes. The purpose of this study was to clarify these differences in a longitudinal cohort study. ⋯ Contrary to prior studies, our longitudinal data indicated that deterioration in spinal alignment originates in the pelvis for both sex but develops earlier in females than males.
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To raise the diagnostic criteria, classification and treatment strategy of dynamic sagittal imbalance (DSI). ⋯ Our study proposed a quantitative diagnostic criteria and novel classification of DSI. Nonoperative treatment is effective for most DSI patients with ΔSVA < 100 mm, while the majority of DSI patients with ΔSVA ≥ 100 mm need operative intervention.