. Structures such as ligamentum flavum, annulus, and lamina play an important role in the segmental function. We proposed the surgical technique for achieving the sufficient preservation of segmental structures, in spite of sufficient removal of pathologic disc in the L5-S1 using the ligamentum flavum splitting and sealing technique. . We retrospectively analyzed 80 cases that underwent percutaneous endoscopic lumbar discectomy for L5-S1 herniated nucleus pulposus, using the ligamentum flavum splitting and sealing technique between January 2011 and June 2013. Outcomes were assessed using VAS (leg, back), MacNab's criteria, and the immediate postoperative MRI for all patients. Structural preservation was classified as complete, sufficient, and incomplete. . The surgical results are as follows: 65 cases were complete, 15 cases were sufficient, and 0 cases were incomplete. The VAS was decreased at the last follow-up (leg: from 7.91 ± 0.73 to 1.15 ± 0.62; back: from 5.15 ± 0.71 to 1.19 ± 0.75). A favorable outcome (excellent or good outcome by MacNab's criteria) was achieved in 77 patients (96.25%). During the follow-up period, 2 cases (2.5%) of recurrence have occurred. . According to the result, we could obtain the favorable clinical and radiological outcomes while simultaneously removing pathologic discs using the ligamentum flavum splitting and annular fissure sealing technique.
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http://dx.doi.org/10.1155/2016/6250247 | DOI Listing |
Interv Pain Med
December 2024
Department of Rehabilitation, Thomas Jefferson University Hospital, Philadelphia, PA, USA.
A 78-year-old female with a remote history of L3-4 decompression and fusion presented with several months of low back and radicular leg pain. MRI revealed moderate L2-L3 spinal canal stenosis, ligamentum flavum infolding, moderate bilateral foraminal stenosis, and a grade I retrolisthesis. A right sided L2-L3 TFESI was performed using multiplanar fluoroscopic imaging with a subpedicular supraneural approach.
View Article and Find Full Text PDFSpine Surg Relat Res
November 2024
Department of Diagnostic Orthopedics, Tokushima University Graduate School, Institute of Health Sciences, Tokushima, Japan.
Introduction: Full endoscopic spine surgery continues to spread worldwide but has a long learning curve. Conventional endoscopy training uses live pigs or human cadavers, which has disadvantages such as high costs and limited availability. Therefore, this study aimed to develop and evaluate three-dimensional (3D)-printed models for endoscopy training.
View Article and Find Full Text PDFSpine Surg Relat Res
November 2024
Department of Bone and Joint Disease, National Center for Geriatrics and Gerontology, Obu, Japan.
Introduction: Ligamentum flavum (LF) hypertrophy is the main etiological factor in the development of lumbar spinal stenosis (LSS); however, its molecular pathology remains unclear. Histologically, LF hypertrophy is characterized by a reduction in elastic fibers and an increase in collagen fibers. We previously performed miRNA transcriptomic analysis on excised LF from elderly patients with LSS and identified the insulin receptor signaling along with TGFβ-mediated signaling as pathways involved in ligament hypertrophy.
View Article and Find Full Text PDFSpine Surg Relat Res
November 2024
Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan.
Introduction: Preoperative estimations of blood loss are important when planning surgery for cervical spine injuries in older adults. The association between ankylosis and blood loss in perioperative management is of particular interest. This multicenter database review aimed to evaluate the impact of ankylosis on surgical blood loss volume in elderly patients with cervical spine injury.
View Article and Find Full Text PDFRadiol Case Rep
February 2025
Department of Pathology Anatomy, Faculty of Medicine PADJADJARAN University. Dr. Hasan Sadikin Hospital, Bandung, West Java, Indonesia.
Chondrosarcomas are one of malignant tumors in which cartilaginous matrix is produced. It is divided into 2 groups including primary or secondary. Primary chondrosarcomas are the third most common primary malignant tumors of the bone.
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