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Lumbar Spinal Stenosis: Who Should Be Fused? An Updated Review

Lumbar spinal stenosis (LSS) is mostly caused by osteoarthritis (spondylosis). Clinically, the symptoms of patients with LSS can be categorized into two groups; regional (low back pain, stiffness, and so on) or radicular (spinal stenosis mainly presenting as neurogenic claudication). Both of these s...

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Autores principales: Omidi-Kashani, Farzad, Hasankhani, Ebrahim Ghayem, Ashjazadeh, Amir
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Society of Spine Surgery 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4149999/
https://www.ncbi.nlm.nih.gov/pubmed/25187873
http://dx.doi.org/10.4184/asj.2014.8.4.521
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author Omidi-Kashani, Farzad
Hasankhani, Ebrahim Ghayem
Ashjazadeh, Amir
author_facet Omidi-Kashani, Farzad
Hasankhani, Ebrahim Ghayem
Ashjazadeh, Amir
author_sort Omidi-Kashani, Farzad
collection PubMed
description Lumbar spinal stenosis (LSS) is mostly caused by osteoarthritis (spondylosis). Clinically, the symptoms of patients with LSS can be categorized into two groups; regional (low back pain, stiffness, and so on) or radicular (spinal stenosis mainly presenting as neurogenic claudication). Both of these symptoms usually improve with appropriate conservative treatment, but in refractory cases, surgical intervention is occasionally indicated. In the patients who primarily complain of radiculopathy with an underlying biomechanically stable spine, a decompression surgery alone using a less invasive technique may be sufficient. Preoperatively, with the presence of indicators such as failed back surgery syndrome (revision surgery), degenerative instability, considerable essential deformity, symptomatic spondylolysis, refractory degenerative disc disease, and adjacent segment disease, lumbar fusion is probably recommended. Intraoperatively, in cases with extensive decompression associated with a wide disc space or insufficient bone stock, fusion is preferred. Instrumentation improves the fusion rate, but it is not necessarily associated with improved recovery rate and better functional outcome.
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spelling pubmed-41499992014-09-03 Lumbar Spinal Stenosis: Who Should Be Fused? An Updated Review Omidi-Kashani, Farzad Hasankhani, Ebrahim Ghayem Ashjazadeh, Amir Asian Spine J Review Article Lumbar spinal stenosis (LSS) is mostly caused by osteoarthritis (spondylosis). Clinically, the symptoms of patients with LSS can be categorized into two groups; regional (low back pain, stiffness, and so on) or radicular (spinal stenosis mainly presenting as neurogenic claudication). Both of these symptoms usually improve with appropriate conservative treatment, but in refractory cases, surgical intervention is occasionally indicated. In the patients who primarily complain of radiculopathy with an underlying biomechanically stable spine, a decompression surgery alone using a less invasive technique may be sufficient. Preoperatively, with the presence of indicators such as failed back surgery syndrome (revision surgery), degenerative instability, considerable essential deformity, symptomatic spondylolysis, refractory degenerative disc disease, and adjacent segment disease, lumbar fusion is probably recommended. Intraoperatively, in cases with extensive decompression associated with a wide disc space or insufficient bone stock, fusion is preferred. Instrumentation improves the fusion rate, but it is not necessarily associated with improved recovery rate and better functional outcome. Korean Society of Spine Surgery 2014-08 2014-08-19 /pmc/articles/PMC4149999/ /pubmed/25187873 http://dx.doi.org/10.4184/asj.2014.8.4.521 Text en Copyright © 2014 by Korean Society of Spine Surgery http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review Article
Omidi-Kashani, Farzad
Hasankhani, Ebrahim Ghayem
Ashjazadeh, Amir
Lumbar Spinal Stenosis: Who Should Be Fused? An Updated Review
title Lumbar Spinal Stenosis: Who Should Be Fused? An Updated Review
title_full Lumbar Spinal Stenosis: Who Should Be Fused? An Updated Review
title_fullStr Lumbar Spinal Stenosis: Who Should Be Fused? An Updated Review
title_full_unstemmed Lumbar Spinal Stenosis: Who Should Be Fused? An Updated Review
title_short Lumbar Spinal Stenosis: Who Should Be Fused? An Updated Review
title_sort lumbar spinal stenosis: who should be fused? an updated review
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4149999/
https://www.ncbi.nlm.nih.gov/pubmed/25187873
http://dx.doi.org/10.4184/asj.2014.8.4.521
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