: To compare the long-term pain characteristics and its chronic management following minimally invasive spinal (MIS) decompression and open laminectomy with fusion for lumbar stenosis. : The study cohort included patients with a minimum 5-year postoperative follow-up after undergoing either MIS decompression or laminectomy with fusion for spinal claudication. The primary outcome of interest was chronic back and leg pain intensity. Secondary outcome measures included pain frequency during the day, chronic use of non-opioid analgesics, narcotic medications, medical cannabinoids, and continuous interventional pain treatments. : A total of 95 patients with lumbar spinal stenosis underwent one- or two-level surgery for lumbar spinal stenosis between April 2009 and July 2013. Of these, 50 patients underwent MIS decompression and 45 patients underwent open laminectomy with instrumented fusion. In the fusion group, a higher percentage of patients experienced moderate-to-severe back pain with 48% compared to 21.8% of patients in the MIS decompression group ( < 0.01). In contrast, we found no significant difference in the reported leg pain in both groups. In the fusion group, 20% of the patients described their back and leg pain as persistent throughout the day compared to only 2.2% in the MIS decompression group ( < 0.05). A trend toward higher chronic dependence on analgesic medication and repetitive pain clinic treatments was found in the fusion group. : MIS decompression for the treatment of degenerative spinal stenosis resulted in decreased long-term back pain and similar leg pain outcomes compared to open laminectomy and instrumented fusion surgery.
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http://dx.doi.org/10.3390/medicina57101125 | DOI Listing |
Asian Spine J
January 2025
Department of Orthopaedic Surgery and Traumatology, Hospital San Rafael, A Coruña, Spain.
Minimally invasive spine surgery (MIS) has shown promising results, and endoscopic spine surgery has emerged as a less invasive approach. Although studies have examined the effectiveness of endoscopic surgery for spinal stenosis, no meta-analyses have focused on multilevel cases. This meta-analysis aimed to evaluate the efficacy and safety of uniportal and biportal endoscopy in patients with multilevel spinal stenosis.
View Article and Find Full Text PDFJ Orthop Case Rep
January 2025
Spine Surgery Unit, Department of Orthopedics, Tan Tock Seng Hospital, Singapore.
Introduction: Surgeries in the occipitocervical and upper cervical region are always quite challenging and need adequate surgical experience and expertise. Especially in cases, where both anterior and posterior surgical access is required, complication rates could be significantly high. The transoral approach for the ventral pathologies of the upper cervical region has been previously described using the conventional open technique where post-operative morbidity is a concern.
View Article and Find Full Text PDFNeurospine
December 2024
Department of Neurosurgery, Spine and Spinal Cord Institute, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Objective: Spinal stenosis is a prevalent condition; however, the optimal surgical treatment for central lumbar stenosis remains controversial. This study compared the clinical outcomes and radiological parameters of 3 surgical.
Methods: unilateral laminectomy bilateral decompression with unilateral biportal endoscopy (ULBD-UBE), conventional subtotal laminectomy (STL), and minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF).
EClinicalMedicine
January 2025
Department of Neurosurgery and Chinese Evidence-Based Medicine Centre and Cochrane China Centre and MAGIC China Centre and IDEAL China Centre, West China Hospital, Sichuan University, Chengdu, China.
Background: Surgical interventions for spontaneous supratentorial intracerebral haemorrhage (ICH) include conventional craniotomy (CC), decompressive craniectomy (DC), and minimally invasive surgery (MIS), with the latter encompassing endoscopic surgery (ES) and minimally invasive puncture surgery (MIPS). However, the superiority of surgery over conservative medical treatment (CMT) and the comparative benefits of different surgical procedures remain unclear. We aimed to evaluate the efficacy and safety of various surgical interventions for treating ICH.
View Article and Find Full Text PDFJ Neurosurg Spine
November 2024
1Division of Neurosurgery, Department of Surgery, University of Toronto.
Objective: This systematic review and meta-analysis compared minimally invasive surgery (MIS) to open surgery for treatment of spinal metastases with respect to perioperative outcomes. Few studies have systemically assessed the body of evidence on this topic.
Methods: A systematic review of EMBASE and PubMed from database inception to December 2023 was performed to identify studies comparing MIS with open surgery for the treatment of spine metastases.
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