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Surgical versus non-surgical treatment for lumbar spinal stenosis – Spinal Stenosis Facts

Background: Lumbar spinal stenosis (LSS) is a debilitating situation connected to degeneration of the backbone with growing older.

Objectives: To seize into consideration the effectiveness of various kinds of surgical operation in comparison with different kinds of non-surgical interventions in adults with symptomatic LSS. Well-known outcomes incorporated quality of lifestyles, disability, just and pain. Furthermore, to seize into consideration complication charges and side effects, and to seize into consideration brief-, intermediate- and long-term outcomes (six months, six months to 2 years, 5 years or longer).

Search strategies: We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, 5 other databases and two trials registries as a lot as February 2015. We additionally screened reference lists and convention proceedings connected to therapy of the backbone.

Desire requirements: Randomised managed trials (RCTs) evaluating surgical versus non-operative treatments in people with lumbar spinal stenosis confirmed by medical and imaging findings.

Files sequence and analysis: For knowledge sequence and analysis, we followed strategies guidelines of the Cochrane Again and Neck Overview Group (Furlan 2009) and these equipped in the Cochrane Handbook for Systematic Experiences of Interventions (Higgins 2011).

Well-known results: From the 12,966 citations screened, we assessed 26 elephantine-textual speak articles and incorporated 5 RCTs (643 people).Low-quality proof from the meta-analysis performed on two trials the usage of the Oswestry Incapacity Index (pain-connected disability) to review teach decompression with or without fusion versus multi-modal non-operative care showed no considerable variations at six months (imply distinction (MD) -3.66, 95% self assurance interval (CI) -10.12 to 2.80) and at one yr (MD -6.18, 95% CI -15.03 to 2.66). At 24 months, considerable variations favoured decompression (MD -4.43, 95% CI -7.91 to -0.96). Low-quality proof from one tiny watch published no distinction in pain outcomes between decompression and current conservative care (bracing and exercise) at three months (likelihood ratio (RR) 1.38, 95% CI 0.22 to 8.59), four years (RR 7.50, 95% CI 1.00 to 56.48) and 10 years (RR 4.09, 95% CI 0.95 to 17.58).Low-quality proof from one tiny watch suggested no variations at six weeks in the Oswestry Incapacity Index for patients treated with minimally invasive collected decompression versus these treated with epidural steroid injections (MD 5.70, 95% CI 0.57 to 10.83; 38 people). Zurich Claudication Questionnaire (ZCQ) results had been higher for epidural injection at six weeks (MD -0.60, 95% CI -0.92 to -0.28), and visible analogue scale (VAS) improvements had been higher in the collected decompression community (MD 2.40, 95% CI 1.92 to 2.88). At 12 weeks, many execrable-overs carried out without extra analysis.Low-quality proof from a single watch in conjunction with 191 people favoured the interspinous spacer versus current conservative therapy at six weeks, six months and one yr for symptom severity and physical just.All ultimate experiences reported issues connected to surgical operation and conservative side effects of therapy: Two experiences reported no predominant issues in the surgical community, and the opposite watch reported issues in 10% and 24% of people, in conjunction with spinous course of break, coronary ischaemia, respiratory pain, haematoma, stroke, likelihood of reoperation and death attributable to pulmonary oedema.

Authors' conclusions: We procure got very small self assurance to diagram whether or not surgical therapy or a conservative come is higher for lumbar spinal stenosis, and we are in a position to provide no new suggestions to files medical apply. On the opposite hand, it wants to be famed that the velocity of side effects ranged from 10% to 24% in surgical circumstances, and no side effects had been reported for any conservative therapy. No sure advantages had been noticed with surgical operation versus non-surgical therapy. These findings imply that clinicians wants to be very careful in informing patients about that you just would additionally imagine therapy alternate ideas, especially on condition that conservative therapy alternate ideas procure resulted in no reported side effects. Excessive-quality research is wanted to review surgical versus conservative love participants with lumbar spinal stenosis.

Read more from the distinctive supply:
Surgical versus non-surgical therapy for lumbar spinal stenosis – PubMed

Background: Lumbar spinal stenosis (LSS) is a debilitating situation connected to degeneration of the backbone with growing older. Objectives: To seize into consideration the effectiveness of various kinds of surgical operation in comparison with different kinds of non-surgical interventions in adults with symptomatic LSS. Well-known outcomes incorporated quality of lifestyles, disability, just and pain. Furthermore, to seize into consideration complication charges and…

At the London Backbone Unit we specialise in the therapy of this situation. The exercise of specialist instruments and anaesthetic ways, our world leading specialists exercise developed ways in which steer clear of the elimination of too noteworthy bone and take care of spinal stenosis the usage of revolutionary surgical ways. Our patients assuredly scoot home on the identical day after surgical operation ie drag in and drag out identical day surgical operation.



That you can additionally additionally are looking out to be taught: Dynamic Backbone Stabilisation Surgical operation

Surgical therapy of spinal stenosis

Day Case Complex Backbone Surgical operation

About day case surgical operation

At Harley Road Effectively being center, we provide day case spinal stenosis surgical operation performed by a highly certified workforce of surgeons. This offers patients with a pair of advantages, such because the next:

-Shorter sanatorium stays. As a consequence of this and to preventive measures, decrease likelihood of contracting COVID-19.

-We educate local anaesthesia, avoiding current anaesthesia and its issues.

-Decrease an infection charges.

-Fewer put up-surgical operation issues.

-Much less expensive than surgical operation requiring an overnight attach.


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What is spinal stenosis?

The spinal stenosis is a narrowing of the spinal canal in the lower part of the spine. This narrowing puts pressure on the spinal cord and/or nerves.

What is the non-surgical treatment of spinal stenosis?

Most cases of spinal stenosis are successfully treated with non-surgical techniques, such as pain relievers and anti-inflammatories. Severe pain can also be treated with corticosteroids that are injected into the lower back (that is, epidural steroid injections). Physical therapy exercises are also prescribed.

What is the surgical treatment of spinal stenosis?

The most common surgery for spinal stenosis is known as a decompressive laminectomy, and it involves removing the lamina (roof) of the vertebra, which increases the space for nerves in the spinal canal. If only part of the lamina needs to be removed, it is known as a laminectomy. If there are herniated discs or bulging discs, they may also be removed (called a discectomy) to increase the space. Sometimes it is also necessary to enlarge the foramen (the area where the nerve roots exit the spinal canal).

Truspilot Reviews

Fabulous service Fabulous service. Mr Akmal truly cares about his patients and how he can improve their quality of life. I would recommend him to anyone with any kind of spinal issue.
Honeywell Paul
Honeywell Paul
Truly excellent results! I was diagnosed with lumbar stenosis after experiencing increasing pain in both legs. An MRI and consultation carried out at short notice confirmed this. Mr Akmal recommended that a spacer should be inserted in my lower back to correct the problem and release the nerves from the narrowing caused by stenosis. The operation was conducted very professionally and without pain. After the first two weeks the pain started to subside as expected. After 4 weeks I was completely back to normal. The result is exceptionally good and I feel renewed, with no pain whatsoever and a regained posture, ready to resume a normal life. I cannot recommend The London Spine Unit highly enough. They are medical magicians!
c etri
c etri
Sciatica My mother was in absolute agony for more than 3 months due to sciatica. It just came out of nowhere and took her out of action. From working full time she went straight to being bed bound and unable to carry out simplest of actions.The pain was 9/10 and she was bed bound for those three months. Multiple trips to A&E and GP and they wouldn't class it as an emergency therefore they wouldn't do anything about it other than upgrading the painkillers which did next to nothing for my mother. I couldn't bear to watch my mother sleeping on A&E bench in pain for 7 hours, just to be told by doctors that she wouldn't be kept in. I remember her joining her hands and begging the doctors to stop the pain which broke my heart. I then started doing research on google and London spine unit came up with Dr Mo AKMAL's profile and review. First meeting with Dr AKMAL was via ZOOM as my mother was bed bound. Dr AKMAL spoke to me and my mom and told us that this is nothing to worry about and that the pain would be 100% gone.Dr AKMAL assured us to visit the hospital so he could physically inspect my mother and give us the best solution. One trip to the london spine unit and Dr AKMAL advised us that the best solution would be to carry out Minimally invasive disectomy. Dr AKMAL advised that due to my mother being bed bound for a while, steroid injection might not give the result that my mother wishes. Dr AKMAL was very confident and showed us some videos from other patients who had gone through the same ordeal. The biggest thing i noticed between before and after was the smile on the patients face. Dr AKMAL was constantly assuring my mother throughout the meeting that he would take care of her pain and gave her 100% confidence that the result would be delivered.He promised her that she would be walking pain free the same day after the operation. Before the operation Dr GURUNG was consulted multiple times and he also was very helpful. Right after the surgery, as Dr AKMAL promised, my mother was walking and the biggest thing was that the pain was gone. My mother had forgotten to smile for three months and there i saw her smiling again. Dr AKMAL and Dr GURUNG gave us brilliant aftercare and informed us that just give them a ring if there was any issue. Its been several weeks now and my mother is heading towards complete recovery without any issues. The pain is completely gone and anyone who is reading this going through the same horrible sciatica pain you must come and see Dr AKMAL. Thank you Dr AKMAL and your whole team for helping my mom achieve this pain free life.
Frank Otuo
Frank Otuo
Extraordinary Care My 81 year old mother who has retired in Ghana was suffering from severe lower back pain so a local surgeon put her through discectomy with hardware (spine screws). The procedure was essentially botched, with one screw breaching her spinal canal resulting in extreme pain; unable to walk, pins and needles and numbness in the left leg. The hardware subsequently had become infected and loosened as a result. Her life after this surgery was the worse she has ever experienced in all her life. She had no doubt that she was eventually to die from the infection and pain. Fortunately, through diligent search, we found Mr Akmal and his team at The UK Spine Centre. She had a zoom consultation and with a ready MRI and CT scan, Mr Akmal knew exactly how to have her back to fitness and a better quality of life. She travelled to England on 26 March 2022 and had the surgery on 11 April 2022. It was a day-case. It lasted no more than 1 hour 30 minutes. She was on my feet within 2 hours pain free - still pain free 5 weeks on! To her this is simply a miracle ! She is grateful to Jehovah God for Mr Akmal and his team - thoroughly professional bunch at the top of their game. No one deserves to suffer the pain she experienced for two years. She seriously recommends Mr Akmal and his team for anything SPINE!
Luke O'Brien
Luke O'Brien
Bilateral discectomy and dynamic stabilisation for complete foot drop From the first phone call, the team at London Spine have been amazing. I had severe symptoms following an L4/L5 disc injury from playing sports and had complete foot drop. Mr Akmal and his team treated the situation incredibly sensitively, as I had risk of permanent damage. The whole process was so quick, from initial consultation to operation was about 96 hours. On the day of the operation, the nurses couldn’t have been more helpful, attentive and calming. The surgery was flawless, with absolutely zero pain from the operation following. I am now 8 weeks from a bi-lateral discectomy and dynamic stabilisation procedure and have regained full use of my leg and toes, with a complete range of motion also. Mr Akmal’s aftercare has been first class, with regular calls from his team in the 2 weeks following the surgery, to the final consultation and discharge. Thanks so much for giving me my life back
Excellent treatment Mr Mo Akmal treated me very successfully for 2 torn discs in my back. I was in tremendous pain before I was referred to him. The treatment I received from him was excellent and he communicated with me very well throughout the whole process. I am eternally grateful to Mr Akmal for sorting out my back and would highly recommend him.
shahnaz Choudhury
shahnaz Choudhury
I had a massive bulging disk on my back… I had a massive bulging disk on my back compressing my nerve for three years. It caused me excruciating pain and almost left me disabled. I was on both crutches and completely homebound due to the severity of pain and mobility limitations. I had my lumber surgery two weeks ago and walked out of hospital within a few hours pain free on my right leg that was almost paralysing prior to surgery. The disk was shaved off releasing the nerve completely. Two days after surgery I had excruciating pain on my head that is unexplained as I had CT scan and MRI which were all fine. Dr Akmal has suggested it could be from the anaesthetic. I am extremely grateful to Dr Akmal and his very welcoming and cari g team. I would highly recommend his clinic as I have had excellent recovery.
Thank you Mr Aklam After having a poor and very slow experiance in glasgow . I contacted Mr mo Amlam . Who is a true gentleman, great listener and paitent . We transfered my scans and treatments from glasgow to harley street . Mr Aklams p.a arranged a quick zoom to start our contact .I then went down for a meeting and examination and what should have been a spec scan .only to be told of a UK shortage . So 4 weeks later the scan took place in wellington hospital . Before I traveled back to glasgow. 5 days later I got a call to book me in to 19 harley street for a l3 and l4 debridement and stabilisation. The opp took place on 24th March. 2hours I was out walking 4 hours later . My pain in back groin and foot was all gone .thanks to Mr aklam . Top of his craft but more importantly pouts his patients first .he really wants to help you get better. Thank you so much Mr Robert harvey
Ken Carswell
Ken Carswell
Amazing service and an amazing treatment! I can't thank Mr Akmal and team at the London Spine Unit enough for their help. I had a herniated disc in my back which was causing pain and restrictions. Compared to other offers of surgery (e.g. several nights in hospital), the day surgery and minimally invasive procedure were hugely appealing. I am now 3 weeks post surgery, have no pain and am recovering incredibly quickly if I compare myself to friends who have had a similar procedure. it was truly remarkable, straightforward and the team were kind, friendly and always helpful. very highly recommended!
Great service and painless procedure Great service and painless procedure. Definitely alleviated the pain

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.

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Narrowing of Spinal Canal

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.

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