19 Harley St, London, W1G 9QJ, UK

Indirect Decompression For The Treatment Of Degenerative Lumbar Stenosis London Spine

The London Spine Unit : most advanced spinal facility in the world

Published article

CONCLUSIONS: Indirect decompression via ALIF was effective in treating appropriately selected patients with degenerative lumbar spinal stenosis. Older patients are at higher risk for failure of indirect decompression-potentially because of greater osseous stenosis as well as subsidence due to age-related diminished bone density with subsequent loss of distraction.
Lumbar Disc Replacement Expert. Best Spinal Surgeon UK

Abstract

Background: Surgical treatment of symptomatic lumbar stenosis has traditionally included laminectomy for direct decompression. With increasing options for lumbar interbody fusion, there has been growing interest in indirect decompression to treat degenerative stenosis. The primary purpose of this study was to determine whether indirect decompression via anterior lumbar interbody fusion (ALIF) can provide symptomatic relief in patients with lumbar spinal stenosis. Secondary purposes were to (1) identify risk factors for failure of indirect decompression and (2) to identify risk factors for failure to obtain relief and to compare outcomes between patients undergoing stand-alone ALIF versusand those in whom ALIF was supplemented with posterior instrumentation.

Methods: Chart review was performed on a consecutive series of 568 patients undergoing single-level ALIF without posterior decompression to treat degenerative stenosis during a 5-year period. Failure of indirect decompression was defined as return to the operating room for direct decompression. Subgroup analysis was performed to compare patients who underwent stand-alone ALIF (n = 247) vs those in whom supplemental posterior instrumentation was used (ALIF + PI; n = 321).

Results: Reoperation due to failure of indirect decompression occurred in 4.0% (23/568) of patients. The only factor related to failure was age. Patients older than 60 years were more likely to fail indirect decompression than were younger patients (7.0% vs 3.1%, P < 0.05). ALIF and ALIF + PI subgroups both improved significantly when comparing preoperative to postoperative mean scores on Oswestry Disability Index (ODI), back pain, and leg pain (all P < 0.01). There were no significant differences between these groups, including reoperation rate for direct decompression.

Conclusions: Indirect decompression via ALIF was effective in treating appropriately selected patients with degenerative lumbar spinal stenosis. Older patients are at higher risk for failure of indirect decompression-potentially because of greater osseous stenosis as well as subsidence due to age-related diminished bone density with subsequent loss of distraction.

Level of evidence: 4.

Clinical relevance: This study supports that indirect decompression via ALIF is a viable alternative to direct decompression in appropriately selected patients with degenerative stenosis.

Keywords: anterior lumbar interbody fusion; clinical outcome; indirect decompression; lumbar spine; re-operation; spinal stenosis.

The London Spine Unit : most advanced spinal facility in the world

Read the original publication:

Indirect Decompression for the Treatment of Degenerative Lumbar Stenosis

Related Posts

0/5 (0 Reviews)

Trusindex Reviews

London Spine Unit Harley Street Hospital

A Focus on High Quality Specialised Care

We are a specialist Private Hospital based on Harley Street, London UK The Harley Street Hospital, Day Surgery Hospital

We provide exclusive health services for individuals seeking Advanced medical, non-surgical or minimally invasive treatments. We are covered by All Insurance Companies apart from AXA PPP

Our Medical Director and Lead Spinal Surgeon Mr Mo Akmal MD is a world renowned Spine Specialist Consultant with over 20 years of experience. He and his team have developed revolutionary techniques to perform all types of Spinal Surgery as a Day Case procedure without traditional General Anaesthetic.

We are constantly improving our techniques for treatment and improving facilities for our patients.

Book your Appointment Now 
Check out our Reviews 
Check out our Patient Videos 
Check our Mr Akmal’s Profile

 

What our patients say ...

Abstract Background: Surgical treatment of symptomatic lumbar stenosis has traditionally included laminectomy for direct decompression. With increasing options for lumbar interbody fusion, there has been growing interest in indirect decompression to treat degenerative stenosis. The primary purpose of this study was to determine whether indirect decompression via anterior lumbar interbody fusion (ALIF) can provide symptomatic…

Revolutionary Keyhole surgical technique to vaporise bulging discs

Dr Mo Akmal Medical Director
Dr Mo Akmal MD - Lead Spinal Surgeon

Laser Disc Surgery can be performed under local anaesthetic at The Harley Street Hospital.

Initial Consultation

with Consultant Spine Surgeon
£ 250
  • No Waiting Times
  • Top NHS affiliated Consultant
  • Includes Clinical Review and Report
  • Multidisciplinary discussion
  • Review of Previous Scans and Reports

Follow up Consultation

any appointment after initial consultation
£ 180
  • Top NHS affiliated Consultant
  • Includes Clinical Review and Report
  • Multidisciplinary discussion

High Resolution MRI Scan

any Single Region (3.0 Tesla)
£ 600
  • No waiting times
  • Includes Full Radiologist Report
  • Open or Closed MRI scan types
  • Copy of Scan on CD

Website Offer

Pre-Booked Online
£1130
£ 800
  • Initial Consultation
  • MRI Scan (Single Region)
  • Follow Up consultation
  • Same Day One Stop Visit
  • Full Medical and MRI scan Report
  • Copy of scan on CD
Popular

If you have any emergency Doctor’s need, simply call our 24 hour emergency

Your personal case manager will ensure that you receive the best possible care.

Call Now 

+44 844 589 2020
+44 203 973 8810