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Only fixation for lumbar canal stenosis: Report of an experience with seven cases

STUDY DESIGN AND OBJECTIVE: The author reports experience with treatment of degenerative lumbar canal stenosis that involved fixation-arthrodesis of the affected spinal segment using “double insurance” transarticular screws for each joint. No direct bone, ligament or disc resection is done for decom...

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Autor principal: Goel, Atul
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4085905/
https://www.ncbi.nlm.nih.gov/pubmed/25013342
http://dx.doi.org/10.4103/0974-8237.135210
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author Goel, Atul
author_facet Goel, Atul
author_sort Goel, Atul
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description STUDY DESIGN AND OBJECTIVE: The author reports experience with treatment of degenerative lumbar canal stenosis that involved fixation-arthrodesis of the affected spinal segment using “double insurance” transarticular screws for each joint. No direct bone, ligament or disc resection is done for decompression of the spinal dural tube or root canal. METHODS AND SUMMARY OF BACKGROUND DATA: During the period March 2011-September 2011, seven patients having lumbar canal stenosis were treated with a modification of transarticular method of screw fixation that involved insertion of two or “double insurance” screws at each articular joint. The operation involved section of the spinous process at its base, opening up of the facet joint, denuding of articular cartilage, insertion of intra-articular bone graft and insertion of two transarticular screws at each facet joint. The fixation was done in four levels in two patients, at three levels in four patients and at two levels in one patient. Oswestry disability index and visual analog scale were used to clinically assess the patients before and after the surgery and at follow-up. RESULTS: During the average period of follow-up of 26.9 months (range 24-30 months), there was varying degree of recovery of symptoms. The procedure resulted in firm stabilization and fixation of the spinal segment and provided a ground for arthrodesis. During the period of follow-up, one patient underwent re-exploration and decompressive laminectomy as she continued to have significant pain symptom. CONCLUSIONS: Vertical instability and telescoping, listhesis or overriding of the facets on physical activity seems to be the defining phenomenon in the pathogenesis of lumbar canal stenosis. The clinical outcome in our patients suggest that fixation of the spinal segment can be a rationale form of treatment. “Double insurance” transarticular method of treatment is a simple, safe, and effective method of spinal stabilization.
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spelling pubmed-40859052014-07-10 Only fixation for lumbar canal stenosis: Report of an experience with seven cases Goel, Atul J Craniovertebr Junction Spine Original Article STUDY DESIGN AND OBJECTIVE: The author reports experience with treatment of degenerative lumbar canal stenosis that involved fixation-arthrodesis of the affected spinal segment using “double insurance” transarticular screws for each joint. No direct bone, ligament or disc resection is done for decompression of the spinal dural tube or root canal. METHODS AND SUMMARY OF BACKGROUND DATA: During the period March 2011-September 2011, seven patients having lumbar canal stenosis were treated with a modification of transarticular method of screw fixation that involved insertion of two or “double insurance” screws at each articular joint. The operation involved section of the spinous process at its base, opening up of the facet joint, denuding of articular cartilage, insertion of intra-articular bone graft and insertion of two transarticular screws at each facet joint. The fixation was done in four levels in two patients, at three levels in four patients and at two levels in one patient. Oswestry disability index and visual analog scale were used to clinically assess the patients before and after the surgery and at follow-up. RESULTS: During the average period of follow-up of 26.9 months (range 24-30 months), there was varying degree of recovery of symptoms. The procedure resulted in firm stabilization and fixation of the spinal segment and provided a ground for arthrodesis. During the period of follow-up, one patient underwent re-exploration and decompressive laminectomy as she continued to have significant pain symptom. CONCLUSIONS: Vertical instability and telescoping, listhesis or overriding of the facets on physical activity seems to be the defining phenomenon in the pathogenesis of lumbar canal stenosis. The clinical outcome in our patients suggest that fixation of the spinal segment can be a rationale form of treatment. “Double insurance” transarticular method of treatment is a simple, safe, and effective method of spinal stabilization. Medknow Publications & Media Pvt Ltd 2014 /pmc/articles/PMC4085905/ /pubmed/25013342 http://dx.doi.org/10.4103/0974-8237.135210 Text en Copyright: © Journal of Craniovertebral Junction and Spine http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Goel, Atul
Only fixation for lumbar canal stenosis: Report of an experience with seven cases
title Only fixation for lumbar canal stenosis: Report of an experience with seven cases
title_full Only fixation for lumbar canal stenosis: Report of an experience with seven cases
title_fullStr Only fixation for lumbar canal stenosis: Report of an experience with seven cases
title_full_unstemmed Only fixation for lumbar canal stenosis: Report of an experience with seven cases
title_short Only fixation for lumbar canal stenosis: Report of an experience with seven cases
title_sort only fixation for lumbar canal stenosis: report of an experience with seven cases
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4085905/
https://www.ncbi.nlm.nih.gov/pubmed/25013342
http://dx.doi.org/10.4103/0974-8237.135210
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