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Decompression Fusion Surgery And Minimally Invasive Microsurgical Decompression In Patients With Single-Segment Lumbar Spinal Stenosis London Spine Lumbar Stenosis

The article compares the clinical efficacy of decompression/fusion surgery and minimally invasive microsurgical decompression in patients with single-segment lumbar spinal stenosis. The study included 196 patients divided into two groups: one group underwent TLIF + transpedicular interbody fusion surgery and the other group underwent MMD. The researchers analyzed pain syndrome and working capacity using visual analogue scale and Oswestry Disability Index. The results showed stable relief of pain syndrome in both groups, but the MMD group had significantly higher scores for lower back and leg pain in the long-term follow-up period

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : most specialised spinal clinic on Harley Street UK

Published article

Analysis of postoperative outcomes in patients with single-segment degenerative lumbar spinal stenosis revealed similar clinical effectiveness of TLIF + transpedicular interbody fusion and MMD regarding decompression quality. However, MMD was associated with less traumatization of paravertebral tissues, blood loss, fewer unwanted phenomena and earlier recovery.

Spine Lumbar Spinal Stenosis Expert. Best Spinal Surgeon UK
Abstract in English, Russian There are few studies comparing clinical efficacy of decompression/fusion surgery (transforaminal lumbar interbody fusion (TLIF) + transpedicular interbody fusion) and minimally invasive microsurgical decompression (MMD) in patients with single-segment lumbar spinal stenosis. Objective: To compare the results of TLIF + transpedicular interbody fusion and MMD in patients with single-segment lumbar spinal,

Abstract

There are few studies comparing clinical efficacy of decompression/fusion surgery (transforaminal lumbar interbody fusion (TLIF) + transpedicular interbody fusion) and minimally invasive microsurgical decompression (MMD) in patients with single-segment lumbar spinal stenosis.

Objective: To compare the results of TLIF + transpedicular interbody fusion and MMD in patients with single-segment lumbar spinal stenosis.

Material and methods: A retrospective observational cohort study included medical records of 196 patients (100 (51%) men, 96 (49%) women). Age of patients ranged from 18 to 84 years. Mean postoperative follow-up period was 20.1±6.7 months. Patients were divided into 2 groups: group I (control) included 100 patients who underwent TLIF + transpedicular interbody fusion, group II (study) included 96 patients who underwent MMD. We analyzed pain syndrome and working capacity using visual analogue scale (VAS) and Oswestry Disability Index (ODI), respectively.

Results: Analysis of pain syndrome in both groups after 3, 6, 9, 12 and 24 months clearly demonstrated stable relief of pain syndrome (VAS score) in the lower extremities. In group II, VAS score of lower back and leg pain was significantly higher in long-term follow-up period (after 9 months or more) compared to the 1st group (p<0.05). In long-term follow-up period (after 12 months), there was significant decrease in degree of disability (ODI score) in both groups (p<0.001) without between-group differences. We assessed achievement of treatment goal in 12 and 24 months after surgery in both groups. The result was significantly better in the 2nd group. At the same time, some respondents failed to achieve the final clinical goal of treatment in both groups (group I – 8 (12.1%), group II – 2 (3%) patients).

Analysis of postoperative outcomes in patients with single-segment degenerative lumbar spinal stenosis revealed similar clinical effectiveness of TLIF + transpedicular interbody fusion and MMD regarding decompression quality. However, MMD was associated with less traumatization of paravertebral tissues, blood loss, fewer unwanted phenomena and earlier recovery.

A search of literature sources in leading scientific databases demonstrated the existence of single studies comparing the clinical effectiveness of decompression with stabilization (Transforaminal Lumbar Interbody Fusion + transpedicular stabilization) and minimally invasive microsurgical decompression (Minimally invasive Microsurgical Decompression – MMD) in patients with monosegmental lumbar spinal stenosis .

Purpose of the study: Comparative analysis of the results of using decompression techniques with stabilization and MMD in patients with monosegmental lumbar stenosis.

Material and methods: A retrospective observational cohort study was performed. Clinical and instrumental parameters were studied according to 196 medical records of patients (100 (51%) men, 96 (49%) women). The age of the patients varied from 18 to 84 years. The average period of postoperative follow-up was 20.1±6.7 months. Patients were divided into two groups: the 1st group (control) included 100 people who underwent decompression with stabilization, the 2nd group (study) included 96 people who underwent MMD. When analyzing the outcomes, pain syndrome was assessed by the visual pain scale (VAS), the degree of working capacity was assessed by the Oswestry Disability Index (ODI).

Results: Assessment of pain syndrome dynamics 3, 6, 9, 12, and 24 months after surgery clearly demonstrated a persistent decrease in the intensity of pain according to VAS in the lower extremities in both groups of patients. In the 2nd group, the intensity of pain in the lower back and lower extremities according to VAS in the long-term follow-up period (after 9 months or more) was statistically significantly higher than that in the 1st group (p<0,05). В отдаленном периоде наблюдения (спустя 12 мес) отмечено статистически достоверное уменьшение степени нетрудоспособности по ODI в обеих группах пациентов (p<0,001), без межгрупповых различий. В двух группах нами проанализирован уровень достижения цели лечения через 12 и 24 мес после выполнения оперативного вмешательства. Результат был достоверно лучше в группе пациентов, которым проводилась MMD. При этом в обеих группах у части респондентов не удалось достигнуть конечной клинической цели лечения: в 1-й группе — у 8 (12,1%) больных, во 2-й — у 2 (3%).

A comparative analysis of the outcomes of surgical treatment of patients with monosegmental degenerative stenosis of the lumbosacral spine using decompression with stabilization and MMD techniques clearly showed that, with a similar clinical effectiveness of decompression of neural structures, MMD is associated with less traumatization of paravertebral tissues, less blood loss and the number of adverse events. as well as a quick recovery.

Keywords: adverse events; clinical results; decompression fusion surgery; minimally invasive microsurgical decompression; radiological results; single-segment lumbar stenosis.

The London Spine Unit : most specialised spinal clinic on Harley Street UK

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Decompression fusion surgery and minimally invasive microsurgical decompression in patients with single-segment lumbar spinal stenosis

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Abstract in English, Russian There are few studies comparing clinical efficacy of decompression/fusion surgery (transforaminal lumbar interbody fusion (TLIF) + transpedicular interbody fusion) and minimally invasive microsurgical decompression (MMD) in patients with single-segment lumbar spinal stenosis. Objective: To compare the results of TLIF + transpedicular interbody fusion and MMD in patients with single-segment lumbar spinal

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