Volume 2, Issue 2 (9-2016)                   Iran J Neurosurg 2016, 2(2): 6-9 | Back to browse issues page

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Hejazian S E, Dadpour M. Frequency of Instrumentation in Lumbar Spinal Stenosis and Lumbar Disc Herniation. Iran J Neurosurg. 2016; 2 (2) :6-9
URL: http://irjns.org/article-1-37-en.html
1- MD, Assistant Professor of Neurosurgery, Shahid Beheshti Hospital, Babol University of Medical Sciences, Babol, Iran
2- MD, General Physician, Shahid Beheshti Hospital, Babol University of Medical Sciences, Babol, Iran
Abstract:   (9208 Views)

Background & Aim: Lumbosacral pain is extremely common as age increases. Spinal instrumentation is sometimes recommended for lumbar canal stenosis and disk herniation surgery. This study aimed at studying the frequency of instrumentation in patients referring to our center.
Methods & Materials/Patients: This retrospective cross-sectional study included 1200 patients with low back and/or radicular pain who had referred to the Shahid Beheshti and Ayatallah Roohani hospitals from 2013 to 2014 in Babol city. Data were analyzed by t-test and chisquare using SPSS (Version 20).
Results: In this study, 150 of 1200 patients needed surgery for lumbar canal stenosis and/or disk herniation (mean age of 42.21 ± 11.41 years old, ranging from 26-69). Of all patients, 76 were men (50.7%) and 74 women (49.3%). L4-L5 was the most involved level. There was a significant relationship between pathology and gender (p<001). At some levels, either men or women were involved. Moreover, 55 patients (36.7%) underwent surgery with instrumentation and 95 patients (63.3%) without instrumentation. Complete improvement was reported in 102 patients (68%). No significant relationship was observed between the degree of improvement and surgery technique and gender (p=0.78, p=0.72).
Conclusion: Most patients (63.3%) underwent surgery without instrumentation and about one third needed fixation during surgery.

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Type of Study: Research | Subject: Gamma Knife Radiosurgery

1. Ishimoto Y, Yoshimura N, Muraki S, Yamada H, Nagata K, Hashizume H, et al. Associations between radiographic lumbar spinal stenosis and clinical symptoms in the general population: the Wakayama Spine Study. Osteoarthritis Cartilage. 2013; 21: 783–788. doi: 10.1016/j.joca.2013.02.656 PMID:23473979. [DOI:10.1016/j.joca.2013.02.656]
2. Lotfinia I, Ayermelo H, Afsari F. Short-term study results in a group of patients over age 60 suffer from lumbar spinal stenosis. Medical Journal of Tabriz University of Medical Sciences. 2010; 31(3): 85-9.
3. Azimi P, Rezamohammadi H, Nayebaghaei H, Mohseni M. The results of laminectomy on morphological MRI features. Journal Shahid Beheshti Medical University Tehran. 2012; 36(4): 183-8.
4. Mobini B, Nabizadeh N. Results of Laminotomy in Lumbar Canal Stenosis. Journal of bone and joint surgery Iran. 2003(5):13-20.
5. Kalichman L, Guermazi A, Li L, Hunter DJ. Association between age, sex, BMI and CT-evaluated spinal degeneration features. J Back Musculoskelet Rehabil. 2009; 22:189–95. [DOI:10.3233/BMR-2009-0232] [PMID]
6. Kalichman L, Kim DH, Li L, Guermazi A, Hunter DJ. Computed tomography-evaluated features of spinal degeneration: prevalence, intercorrelation, and association with self-reported low back pain. Spine J. 2010; 10: 200–8. [DOI:10.1016/j.spinee.2009.10.018] [PMID] [PMCID]
7. Saeidian SR, Zeinali M, Teimoori A, Latifi SM. Evaluating the frequency of hamstrings muscle Pain and tightness in Patients suffering from lumbosacral spinal Stenosis. Journal of Mashhad University of Medical Sciences. 2014; 57(4): 609-15.
8. Postacchini F. Surgical management of lumbar spinal stenosis. Spine (Phila Pa 1976). 1999; 24(10): 1043-7. [DOI:10.1097/00007632-199905150-00020]
9. Niggemeyer O, Strauss JM, Schulitz KP. Comparison of surgical procedures for degenerative lumbar spinal stenosis: a meta-analysis of the literature from 1975 to1995. European spine journal . 1997; 6(6): 423-9. [DOI:10.1007/BF01834073] [PMID] [PMCID]
10. Johnsson KE, Rosen I, Uden A. The natural course of lumbar spinal stenosis. Clinical orthopaedics and related research. 1992; (279): 82-6. [DOI:10.1097/00003086-199206000-00010]
11. You JJ, Bederman SS, Symons S, Bell CM, Yun L, Laupacis A, et al. Patterns of care after magnetic resonance imaging of the spine in primary care. Spine. 2013; 38: 51–59. doi: 10.1097/BRS. 0b013e3182611182 PMID: 22652596
12. Kovacs FM, Urrútia G, Alarcón JD. Surgery versus conservative treatment for symptomatic lumbar spinal stenosis: a systematic review of randomized controlled trials. Spine. 2011; 36: E1335–1351. doi: 10.1097/BRS.0b013e31820c97b1 PMID: 21311394. [DOI:10.1097/BRS.0b013e31820c97b1]
13. May S, Comer C. Is surgery more effective than non-surgical treatment for spinal stenosis, and which non-surgical treatment is more effective? A systematic review. Physiotherapy. 2013; 99: 12–20. doi:10.1016/j.physio.2011.12.004 PMID: 23219644. [DOI:10.1016/j.physio.2011.12.004]
14. Amini J, Mazloomi M, Reyhani A. Evaluation of Surgical Laminectomy in 14 Cases with Lumbar Spinal Stenosis. Journal of bone and joint surgery Iran. 2004(5):21-4.
15. Farzanegan G. The results of lumbar fusion using pedicle screws in patients with Aspvnd Lystzys. Kowsar Medical Journal. 2007; 11(1): 75-80.
16. Erfani M, Nouraei H, Mesbahi A, Toubaei F. Treatment Outcome of Thoracolumbar/Lumbar Scoliosis with Short Segment Anterior Spinal Fusion. Iranian Journal of Orthopaedic Surgery. 2009; 7(3): 99-107.
17. Mashhadi Nezhad H, Samini F, Mashhadi Nezhad S. Comparison of clinical findings and results of open surgury in treatment of primary and recurrent lumbosacral disc herniation. Journal of Birjand University of Medical Sciences. 2011; 17(4): 288-95.
18. Molaee M, Mablaghi J. Efficacy of Morphine Injection Versus Sublingual Buprenorphine in Postoperative Pain After Lumbar Laminectomy. The Scientific Journal of Kurdistan University of Medical Sciences. 2008; 12(3): 64-72.
19. Oliphant D. Safety of Spinal Manipulation in the Treatment of Lumbar Disk Herniations: A Systematic Review and Risk Assessment. Journal of Manipulative and Physiological Therapeutics. 2004; 27(3): 197-210. [DOI:10.1016/j.jmpt.2003.12.023] [PMID]
20. Yorimitsu E, Chiba K, Toyama Y, Hirabayashi K. Long-Term Outcomes of Standard Discectomy for Lumbar Disc Herniation. Spine (Phila Pa 1976). 2001;26 (6): 652-7. [DOI:10.1097/00007632-200103150-00019]
21. Yabuki Sh, Fukumori N, Takegami M. Prevalence of lumbar spinal stenosis, using the diagnostic support tool, and correlated factors in Japan: a population-based study. J Orthop Sci.2013) 18:893–900 . DOI 10.1007/s00776-013-0455-5. [DOI:10.1007/s00776-013-0455-5]
22. Tabatabaei SM, Seddighi AS, Seddighi A, Gholami A, Rahimi Baghdashti H, Shalchizadeh M. World Spinal Column Journal. 2012; 3(3): 80-86.
23. Casal-Moro R, Castro-Menéndez M, Del Campo-Pérez V, Hernández-Blanco M, Jorge-Barreiro FJ. Learning Curve of Microendoscopic Discectomy for the Treatment of Lumbar Disc Herniation. Revista Espa-ola de Cirugía Ortopédica y Traumatología (English Edition). 2010; 54(5): 272-9. https://doi.org/10.1016/j.recot.2010.05.002 [DOI:10.1016/S1988-8856(10)70246-7]
24. Jabbari M, Kashani K. Familial predisposition for lumbar degenerative disc disease. Scientific Journal of Hamadan University of Medical Sciences. 2005; 11(2): 35-7.
25. Rijin JC, Klemesto N. Symptomatic and asymptomatic abnormalities in patients with lumbosacral radicular syndrome: Clinical examination compared with MRI. Clinical Neurology and eurosurgery. 2006; 108(6): 553-7. [DOI:10.1016/j.clineuro.2005.10.003] [PMID]
26. Kim KY, Kim YT, Lee CS, Kang JS, Kim YJ. Magnetic resonance imaging in the evaluation of the lumbar herniated intervertebral disc. International orthopaedics. 1993; 17(4): 241-4. [DOI:10.1007/BF00194188] [PMID]
27. Barzin M. MRI findings in patients with spinal stenosis. Guilan University of Medical Sciences. 2011; 20(79): 40-8.
28. Brandenberg GA, Traynelis VC. Disc disease of the spinal column. In: Grossman RG, Loftus CM (eds). Principles of neurosurgery. 2nd ed. 1999, pp: 577-593.
29. Fujii K, Henmi T, Kanematsu Y, Mishiro M, Sakai T. Surgical treatment of lumbar disc herniation in elderly patients. The Journal of bone and joint surgery. British volume. 2003 Nov;85(8):1146-50. [DOI:10.1302/0301-620X.85B8.14625] [PMID]
30. Branam BR, Stambough JL. Atypical lumbar disc herniation: a case report. The Spine Journal. 2002; 2(3): 224-6. [DOI:10.1016/S1529-9430(01)00272-8]
31. Padua R, Padua S. Romanini E. Ten to 15 year outcome of surgery for lumbar disc hemiations: radiographic instability and clinical findings. European spine journal. 1999;8(1):70-4. [DOI:10.1007/s005860050129] [PMID] [PMCID]
32. Barrios C, Ahmed M, Arrotegui JI, Björnsson A. Clinical factors predicting outcome after surgery for herniated lumbar disc: an epidemiological multivariate analysis. Journal of spinal disorders. 1990; 3(3): 205-9. [DOI:10.1097/00002517-199009000-00002] [PMID]
33. Junge A, Dvorak J, Ahrens S. Predictors of bad and good outcome of lumbar disc surgery: a prospecLive clinical study with recommendations for screening to avoid bad outcomes. Spine (Phila Pa 1976). 1995; 20(4): 460-8. [DOI:10.1097/00007632-199502001-00009]
34. Thaler M, Lechner R, Foedinger B, Haid C, Kavakebi P, Galiano K, et al. Driving reaction time before and after surgery for disc herniation in patients with preoperative paresis. The Spine Journal. 2015; 15(5): 918-22. [DOI:10.1016/j.spinee.2013.06.052] [PMID]
35. Wang H, Zhang Z, Zhou Y. Irregular Alteration of Facet Orientation in Lumbar Segments: Possible Role in Pathology of Lumbar Disc Herniation in Adolescents. World Neurosurgery. 2016; 86: 321-7. [DOI:10.1016/j.wneu.2015.09.029] [PMID]
36. Mobini B, Behtash H, Ameri et all, Patient Satisfaction after Spinal Decompression in Central Degenerative Spinal Stenosis (An early result). Iranian Journal of Orthopaedic Surgery. (2006): 8-13.
37. Pearson A1, Lurie J, Tosteson T, Zhao W, Abdu W, Weinstein JN. Who should have surgery for spinal stenosis? Treatment effect predictors in SPORT. Spine (Phila Pa 1976). 2012; 37(21): 1791-802. [DOI:10.1097/BRS.0b013e3182634b04] [PMID] [PMCID]
38. Cobo Soriano J, Sendino Revuelta M, Fabregate Fuente M, Cimarra Diaz I, Martinez Urena P, Deglane Meneses R. Predictors of outcome after decompressive lumbar surgery and instrumented posterolateral fusion. European spine journal. 2010; 19: 1841–8. [DOI:10.1007/s00586-010-1284-2] [PMID] [PMCID]
39. Sinikallio S, Aalto T, Airaksinen O, Herno A, Kroger H, Viinamaki H. Depressive burden in the preoperative and early recovery phase predicts poorer surgery outcome among lumbar spinal stenosis patients: a one-year prospective follow-up study. Spine (Phila Pa 1976). 2009; 34: 2573–8. [DOI:10.1097/BRS.0b013e3181b317bd] [PMID]
40. Komori H, Okawa A, Haro H, Shinomiya K-i. Factors predicting the prognosis of lumbar radiculopathy due to disc herniation. Journal of Orthopaedic Science. 2002; 7(1): 56-61. [DOI:10.1007/s776-002-8416-0] [PMID]
41. Dai L-Y, Zhou Q, Yao W-F, Shen L. Recurrent lumbar disc herniation after discectomy: outcome of repeat discectomy. Surgical Neurology. 2005; 64(3): 226-31. [DOI:10.1016/j.surneu.2004.11.003] [PMID]

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