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Semi-Circumferential Decompression: Total En-Bloc Ligamentum Flavectomy to Treat Lumbar Spinal Stenosis with Two-Level Degenerative Spondylolisthesis

INTRODUCTION: Despite technical developments in decompression without fusion, many studies still assert that instability could be increased in patients with spinal stenosis and lumbar degenerative spondylolisthesis after spinal decompression surgery without fusion. Thus, this study aimed to describe...

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Autores principales: Lee, Young Sang, Lee, Soo-Bin, Kim, Jin, Nam, Hyeon-Wook, Kim, Hyung Do, Eun, Dong-Chan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Japanese Society for Spine Surgery and Related Research 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8026212/
https://www.ncbi.nlm.nih.gov/pubmed/33842716
http://dx.doi.org/10.22603/ssrr.2020-0146
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author Lee, Young Sang
Lee, Soo-Bin
Kim, Jin
Nam, Hyeon-Wook
Kim, Hyung Do
Eun, Dong-Chan
author_facet Lee, Young Sang
Lee, Soo-Bin
Kim, Jin
Nam, Hyeon-Wook
Kim, Hyung Do
Eun, Dong-Chan
author_sort Lee, Young Sang
collection PubMed
description INTRODUCTION: Despite technical developments in decompression without fusion, many studies still assert that instability could be increased in patients with spinal stenosis and lumbar degenerative spondylolisthesis after spinal decompression surgery without fusion. Thus, this study aimed to describe and assess the clinical outcomes of the semi-circumferential decompression (SCD) technique used for microsurgical en-bloc total ligamentum flavectomy with preservation of the facet joint in treating patients who have lumbar spinal stenosis with two-level degenerative spondylolisthesis. METHODS: We retrospectively analyzed the clinical and radiologic outcomes of 14 patients who had spinal stenosis with two-level Meyerding grade I degenerative spondylolisthesis. We evaluated improvements in back pain and radiating pain using a visual analogue scale (VAS) and the Oswestry Disability Index (ODI). We have also examined the occurrence of spinal instability on a radiological exam using slip percentage and slip angle. RESULTS: The mean VAS score of back pain and radiating pain has been determined to decrease significantly from 6.7 to 3.3 and from 8.6 to 2.7, respectively. Meanwhile, the ODI score significantly improved from 27.3 preoperatively to 9.8 postoperatively. Statistically significant change was not observed in the slip percentage in both upper and lower levels. Dynamic slip percentage, which is defined as the difference in the slip percentage between flexion and extension, also did not significantly change. No statistically significant change was found in the slip angle and dynamic slip angle. CONCLUSIONS: SCD is a recommendable procedure that can improve clinical results. This procedure does not cause spinal instability when treating patients who have spinal stenosis with two-level degenerative spondylolisthesis.
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spelling pubmed-80262122021-04-08 Semi-Circumferential Decompression: Total En-Bloc Ligamentum Flavectomy to Treat Lumbar Spinal Stenosis with Two-Level Degenerative Spondylolisthesis Lee, Young Sang Lee, Soo-Bin Kim, Jin Nam, Hyeon-Wook Kim, Hyung Do Eun, Dong-Chan Spine Surg Relat Res Original Article INTRODUCTION: Despite technical developments in decompression without fusion, many studies still assert that instability could be increased in patients with spinal stenosis and lumbar degenerative spondylolisthesis after spinal decompression surgery without fusion. Thus, this study aimed to describe and assess the clinical outcomes of the semi-circumferential decompression (SCD) technique used for microsurgical en-bloc total ligamentum flavectomy with preservation of the facet joint in treating patients who have lumbar spinal stenosis with two-level degenerative spondylolisthesis. METHODS: We retrospectively analyzed the clinical and radiologic outcomes of 14 patients who had spinal stenosis with two-level Meyerding grade I degenerative spondylolisthesis. We evaluated improvements in back pain and radiating pain using a visual analogue scale (VAS) and the Oswestry Disability Index (ODI). We have also examined the occurrence of spinal instability on a radiological exam using slip percentage and slip angle. RESULTS: The mean VAS score of back pain and radiating pain has been determined to decrease significantly from 6.7 to 3.3 and from 8.6 to 2.7, respectively. Meanwhile, the ODI score significantly improved from 27.3 preoperatively to 9.8 postoperatively. Statistically significant change was not observed in the slip percentage in both upper and lower levels. Dynamic slip percentage, which is defined as the difference in the slip percentage between flexion and extension, also did not significantly change. No statistically significant change was found in the slip angle and dynamic slip angle. CONCLUSIONS: SCD is a recommendable procedure that can improve clinical results. This procedure does not cause spinal instability when treating patients who have spinal stenosis with two-level degenerative spondylolisthesis. The Japanese Society for Spine Surgery and Related Research 2020-10-09 /pmc/articles/PMC8026212/ /pubmed/33842716 http://dx.doi.org/10.22603/ssrr.2020-0146 Text en Copyright © 2021 by The Japanese Society for Spine Surgery and Related Research https://creativecommons.org/licenses/by-nc-nd/4.0/Spine Surgery and Related Research is an Open Access journal distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. To view the details of this license, please visit (https://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Original Article
Lee, Young Sang
Lee, Soo-Bin
Kim, Jin
Nam, Hyeon-Wook
Kim, Hyung Do
Eun, Dong-Chan
Semi-Circumferential Decompression: Total En-Bloc Ligamentum Flavectomy to Treat Lumbar Spinal Stenosis with Two-Level Degenerative Spondylolisthesis
title Semi-Circumferential Decompression: Total En-Bloc Ligamentum Flavectomy to Treat Lumbar Spinal Stenosis with Two-Level Degenerative Spondylolisthesis
title_full Semi-Circumferential Decompression: Total En-Bloc Ligamentum Flavectomy to Treat Lumbar Spinal Stenosis with Two-Level Degenerative Spondylolisthesis
title_fullStr Semi-Circumferential Decompression: Total En-Bloc Ligamentum Flavectomy to Treat Lumbar Spinal Stenosis with Two-Level Degenerative Spondylolisthesis
title_full_unstemmed Semi-Circumferential Decompression: Total En-Bloc Ligamentum Flavectomy to Treat Lumbar Spinal Stenosis with Two-Level Degenerative Spondylolisthesis
title_short Semi-Circumferential Decompression: Total En-Bloc Ligamentum Flavectomy to Treat Lumbar Spinal Stenosis with Two-Level Degenerative Spondylolisthesis
title_sort semi-circumferential decompression: total en-bloc ligamentum flavectomy to treat lumbar spinal stenosis with two-level degenerative spondylolisthesis
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8026212/
https://www.ncbi.nlm.nih.gov/pubmed/33842716
http://dx.doi.org/10.22603/ssrr.2020-0146
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