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“Only fixation” in cases with failed decompression for lumbar canal stenosis – Analysis of outcome in 14 cases – Lumbar Spinal Stenosis

This article discusses the rationale behind “only fixation” as a treatment approach for cases of failed decompressive laminectomy for lumbar canal stenosis. The study examined 14 patients who experienced symptomatic worsening or no improvement following a long-segment decompressive laminectomy. These patients were then treated with segmental spinal stabilization without bone or soft tissue decompression. The patients were assessed using the Oswestry Disability Index and Visual Analog Scale before and after surgery and during follow-up. The results showed that all patients experienced significant recovery in their major symptoms, with no recurrent symptoms or need for additional surgery during the follow-up period. The treated spinal segments showed firm stabilization and bone fusion, with no infections or implant failure. The study concludes that spinal segment instability is the primary issue in cases of lumbar canal stenosis, and stabilization is an effective treatment approach

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : top spine clinic in UK

Published article

CONCLUSIONS: Instability of the spinal segments is the primary issue in cases with lumbar canal stenosis and stabilization in the treatment.

Lumbar Decompression Surgery Expert. Best Spinal Surgeon UK
J Craniovertebr Junction Spine. 2023 Oct-Dec;14(4):330-335. doi: 10.4103/jcvjs.jcvjs_151_23. Epub 2023 Nov 29.ABSTRACTAIM: The rationale of “only fixation” of affected spinal segments without any form of bone or soft-tissue decompression in cases with failed decompressive laminectomy for lumbar canal stenosis is discussed on the basis of an experience with 14 cases.MATERIALS AND METHODS: During the period,

J Craniovertebr Junction Spine. 2023 Oct-Dec;14(4):330-335. doi: 10.4103/jcvjs.jcvjs_151_23. Epub 2023 Nov 29.

ABSTRACT

AIM: The rationale of “only fixation” of affected spinal segments without any form of bone or soft-tissue decompression in cases with failed decompressive laminectomy for lumbar canal stenosis is discussed on the basis of an experience with 14 cases.

MATERIALS AND METHODS: During the period between 2010 and 2022, 14 patients who symptomatically worsened or did not improve following a long-segment “wide” decompressive laminectomy for multisegmental lumbar canal stenosis were identified. All patients were treated by segmental spinal stabilization aimed at arthrodesis by facetal distraction by Goel’s facetal spacers (6 cases) or Camille’s transarticular facetal fixation (8 cases). No bone, soft tissue, or disc resection was done for spinal or neural canal “decompression.” Oswestry Disability Index and Visual Analog Scale were used to clinically assess the patients before and after the surgery and at follow-up. In addition, video recordings of patient’s self-assessment of clinical outcome were used to monitor the outcome.

RESULTS: During the average period of follow-up of 71 months (range 6 months to 16 years), all patients recovered in majority of their major symptoms, the recovery was observed in the immediate postoperative period. During the period of follow-up, none of the patients complained of recurrent symptoms or needed any additional surgery. There was firm stabilization and evidences of bone fusion of the treated spinal segments in all patients. There were no infections or implant failure. No patient worsened after treatment.

CONCLUSIONS: Instability of the spinal segments is the primary issue in cases with lumbar canal stenosis and stabilization in the treatment.

PMID:38268683 | PMC:PMC10805158 | DOI:10.4103/jcvjs.jcvjs_151_23

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“Only fixation” in cases with failed decompression for lumbar canal stenosis – Analysis of outcome in 14 cases

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J Craniovertebr Junction Spine. 2023 Oct-Dec;14(4):330-335. doi: 10.4103/jcvjs.jcvjs_151_23. Epub 2023 Nov 29.ABSTRACTAIM: The rationale of "only fixation" of affected spinal segments without any form of bone or soft-tissue decompression in cases with failed decompressive laminectomy for lumbar canal stenosis is discussed on the basis of an experience with 14 cases.MATERIALS AND METHODS: During the period

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