Longitudinal DTI analysis of microstructural changes in lumbar nerve roots following Interspinous process device placement.

Diffusion tensor imaging (DTI) and its parameters such as fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), radial diffusivity (RD) are increasingly being used to assess peripheral nerve integrity alongside nerve conduction studies. This pilot study aims to compare DTI values of lumbar spinal nerve roots before (T0) and after (T1) treatment with an interspinous process device (IPD). Seven patients (5 females, 2 males; mean age: 68) suffering from neurogenic claudication and lumbar spinal canal and foraminal stenosis were evaluated.

Management of cerebrospinal fluid leak after a minimally invasive lumbar decompression procedure: illustrative case.

Background: Neurogenic claudication caused by lumbar stenosis is a prevalent disorder of the spinal canal for which many treatment options exist. The mild (minimally invasive lumbar decompression) procedure has recently been introduced as a safe and effective alternative to medical management in the treatment of lumbar stenosis. However, data on complications are rarely reported, and the incidence of complications, when reported, is frequently assessed at 0% in the literature.

Minimally Invasive Endoscopic Spine Surgery as a Viable Option for Geriatric Patients with High Anesthetic Risk.

Spinal stenosis poses a significant healthcare challenge in the United States. This case report delineates the progressive interventions in a male over 90 years of age with lumbar spinal stenosis, emphasizing the shift toward minimally invasive endoscopic spine surgery. The patient, burdened by neurogenic claudication, failed conservative measures, leading to substantial pain and diminished quality of life.

Decompression without Fusion in Patients with Low-Grade Degenerative Spondylolisthesis and Stenosis: Long-Term Patient-Reported Outcome.

Background: One-third of patients with neurogenic claudication caused by lumbar spinal stenosis have low-grade degenerative spondylolisthesis. Decompression in these patients is considered a risk factor for instability, and it remains unclear whether instrumented fusion should be added. This study aims to assess the long-term clinical outcomes of decompressive surgery without instrumented fusion in patients with symptomatic spinal stenosis regardless of low-grade degenerative spondylolisthesis.

Electrodiagnostic Confirmation of Lumbar Radiculopathy and Its Association With Lumbar Central Canal Stenosis and Neuroforaminal Stenosis.

Introduction: Lumbar spinal stenosis (LSS) and lumbar neuroforaminal stenosis (LNS) are common diagnoses that plague patients with low back pain. Electrodiagnostic testing (EDX) can be used as an adjunct to investigate lower extremity radicular nerve pain and/or neurogenic claudication. However, there are only limited studies discussing the association of these diagnostic tools with radiculopathy.

Efficiency of Lidocaine Intramuscular and Intraosseous Trigger Point Injections in the Treatment of Residual Chronic Pain after Degenerative Lumbar Spinal Stenosis Decompression Surgery.

: Despite the long-term use of intramuscular and intraosseous lidocaine trigger point injections (LTPI) in the treatment of patients with low back pain, there have been no studies examining their efficiency in treatment of residual pain after degenerative lumbar spinal stenosis (DLSS) decompression surgery. The purpose of our research is to examine the LTPI efficiency in the treatment of residual lumbar pain after DLSS decompression surgery and to compare the analgesic and recovery effects of intramuscular and intraosseous LTPI administered in the L4-S1 region and in the posterior superior iliac spine (PSIS) after treatment and during four months of follow-up. : We observed 99 patients (F:50, M:49) aged 42 to 59 years with residual neurological disorders after DLSS decompression surgery.

Percutaneous image-guided lumbar decompression and outpatient laminectomy for the treatment of lumbar spinal stenosis: a 2-year Medicare claims benchmark study.

Background: This prospective longitudinal study compares outcomes for Medicare beneficiaries receiving outpatient percutaneous image-guided lumbar decompression (PILD) using the ® procedure to patients undergoing outpatient laminectomy. All patients were diagnosed with lumbar spinal stenosis (LSS) with neurogenic claudication (NC).

Methods: All medical claims for 100 % of Medicare beneficiaries were reviewed, with study subjects identified using Centers for Medicare and Medicaid Research Identifiable Files.

Aortic stenting of coral-reef aorta for claudication of possible neurogenic or ischemic origin - A case report.

Introduction And Importance: Coral-reef type aortic occlusions are uncommon conditions that can result in intermittent claudication. Many claudicants also have concomitant neurogenic aetiologies and revascularization alone may not be beneficial. These cases can prove to be a diagnostic challenge.

A challenge diagnosis of lumbar synovial facet cyst. A case report.

Introduction And Importance: Synovial cysts occur more frequently in the lumbar spine, especially at L4-5 level. Traditional open surgical management with posterolateral arthrodesis is the currently recommended treatment.

Case Presentation: This is a 64-year-old woman with no prior pathological history.

Therapeutic effect of epidural dexamethasone palmitate in a rat model of lumbar spinal stenosis.

Background: Dexamethasone palmitate (DEP), a prodrug of dexamethasone (DEX), is a synthetic corticosteroid medication distinguished by the inclusion of a fatty acid component known as palmitate. This study introduces DEP as a novel therapeutic option for spinal epidural injection, aiming to provide safer and longer-lasting pain relief as an alternative to for patients with spinal stenosis.

Methods: 40 rats were randomly divided into four groups: those receiving epidural administration of normal saline (NS), and DEP in the lumbar spinal stenosis (LSS) model, and non-model rats receiving epidural NS administration.

Effect of Acupuncture on Neurogenic Claudication Among Patients With Degenerative Lumbar Spinal Stenosis : A Randomized Clinical Trial.

Background: Acupuncture may improve degenerative lumbar spinal stenosis (DLSS), but evidence is insufficient.

Objective: To investigate the effect of acupuncture for DLSS.

Design: Multicenter randomized clinical trial.

Pain trajectories over 12 months following conservative care consultation in patients with lumbar spinal stenosis.

Objective: To investigate symptom trajectories in chiropractic patients with lumbar spinal stenosis (LSS).

Methods: Patients diagnosed with LSS were recruited from chiropractic clinics and self-reported questionnaires were collected at baseline and 1-year follow-up. Patients received weekly text messages about low back pain (LBP) and leg symptoms for 1 year.

Association Between Radiological Severity of Lumbar Spinal Stenosis and Spinopelvic Parameters in Adult Patients With Achondroplasia.

Background And Objectives: Adults with achondroplasia are more vulnerable to suffer from neurogenic claudication because of a congenital narrow spinal canal, which makes them susceptible to lumbar spinal stenosis (LSS). The study aims to investigate the correlations between sagittal alignment parameters and the degree of LSS in patients with achondroplasia with LSS.

Methods: The radiological data of adult achondroplasts presented to the neurosurgical clinic of our medical center from 2019 to 2022 were collected.

Slalom technique for multilevel degenerative spinal stenosis, surgical outcome and complication rate: Review of our experience.

Lumbar canal stenosis (LCS) is a common spinal disease affecting the elderly. Primarily it is asymptomatic until there is neurogenic claudication. Minimally invasive surgical (MIS) techniques are used to treat patients with lumbar spinal stenosis (LSS), while tubular system with alternative multilevel decompression is specifically used for those with minimal back pain and no mechanical instability on dynamic imaging.

Ultrasound-guided caudal epidural injection to treat symptoms of lumbar spinal stenosis: a retrospective study.

Lumbar spinal stenosis (LSS) occurs when bony, ligamentous, and synovial elements of the lower axial spine degenerate and overgrow, compressing neural and vascular elements in the spinal canal. Compression can cause static back pain, radicular lower extremity pain, or neurogenic claudication. Radiological and clinical findings are needed to diagnose lumbar stenosis.

Feasibility, safety, and efficacy of a new percutaneous interspinous device: a retrospective multicenter study.

Purpose: To evaluate safety and efficacy of the novel percutaneous interspinous device (PID) for the treatment of symptomatic degenerative lumbar spinal stenosis (DLSS) in 3 different centers.

Methods: From November 2016 to March 2020, 255 patients (male 125, mean age 71.2 years old range 49-91 years old) with neurogenic claudication, confirmed by electromyography, related to mono or bi-segmental lumbar central canal and/or foraminal stenosis were enrolled in the study.

Compensatory upregulation of MT2A alleviates neurogenic intermittent claudication through inhibiting activated p38 MAPK-mediated neuronal apoptosis.

Neurogenic intermittent claudication (NIC), a classic symptom of lumbar spinal stenosis (LSS), is associated with neuronal apoptosis. To explore the novel therapeutic target of NIC treatment, we constructed the rat model of NIC by cauda equina compression (CEC) method and collected dorsal root ganglion (DRG) tissues, a region responsible for sensory and motor function, for mRNA sequencing. Bioinformatic analysis of mRNA sequencing indicated that upregulated metallothionein 2A (MT2A), an apoptosis-regulating gene belonging to the metallothionein family, might participate in NIC progression.

Relationships between the Spinal Dural Pulsations and the Short-Term Efficacy of Lumbar Epidural Steroid Injection.

Background: Lumbar spinal stenosis (LSS) causes low back pain, leg pain, numbness in the leg, and neurogenic intermittent claudication. Epidural steroid injection (ESI) has been used for treating spinal stenosis symptoms. We hypothesized that dural pulsation was variable for lumbar spinal stenosis.

Walking performance in individuals with lumbar spinal stenosis-possible outcome measures and assessment of known-group validity.

Background Context: One of the primary goals of treatments received by individuals with lumbar spinal stenosis with neurogenic claudication is to improve walking ability. Thus, a thorough and valid assessment of walking ability in patients with lumbar spinal stenosis is needed. Duration of continuous walking and steps per day could be relevant when evaluating walking ability in daily living.

Minimally Invasive Revision of Luque Plate Instrumentation: A Case Report.

Extension of existing spinal fusions may necessitate the removal of or linkage to prior constructs. Knowledge of previously placed instrumentation is critical to success in these revision scenarios. The Luque spinal instrumentation system, developed in the late 1980s, is a legacy pedicle screw and plate system that may be encountered during revision operations today.

Is the interspinous process device safe and effective in elderly patients with lumbar degeneration? A systematic review and meta-analysis of randomized controlled trials.

Background Context: Lumbar spinal stenosis is one of the most common diseases affecting the elderly that is characterized by the narrowing of the spinal canal and peripheral neural pathways which may cause back pain and neurogenic intermittent claudication in affected patients. Recently, as an alternative treatment between conservative therapy and decompression surgery, interspinous process device (IPD) such as X-stop, Coflex, DIAM, Aperius, Wallis, etc., has gained enough popularity.

Posterior Lateral Arthrodesis as a Treatment Option for Lumbar Spinal Stenosis: Safety and Early Clinical Outcomes.

Introduction: Lumbar spinal stenosis (LSS) is a common condition caused by degenerative changes in the lumbar spine with age. LSS is caused by a variety of factors, including degenerative spondylosis and spondylolisthesis. People suffering with LSS experience neurogenic claudication, which causes severe physical limitations, discomfort, and a decrease in quality of life.

Supplementary posterior fusion in patients operated on employing TLIF may decrease the instrumentation failure rate.

Background: It is supposed that additional posterior fusion may provide additional stability of the pedicle screw; however, the clinical impact of additional posterior fusion in patients treated with TLIF remains uncertain. The objective of this study is to assess the clinical efficacy of circumferential fusion in patients treated with TLIF.

Materials And Methods: This is a single-center retrospective evaluation of consecutive 179 patients with degenerative lumbar stenosis and instability of spinal segments.