Sublaminar Decompression and Fusion in the Management of Stenotic Lumbar Degenerative Disorders

Background Data: Lumbar degenerative disorders may result in low back pain, leg pain and limitation of walking distance that can disturb the patients’ life. Several surgical procedures have been used to treat spinal canal stenosis ranging from minimal invasive to extensive decompression and fusion....

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Autores principales:	Mohammed Khalid Saleh, MD., Mohamed Adel Abdelrazek, MD., Shamel Elgawhary, MD.
Formato:	article
Lenguaje:	EN
Publicado:	Egyptian Spine Association 2018
Materias:	sublaminar decompression spinal fusion degenerative disorders lumbar spine Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/41946932495348ccba58bbe08a8cf43c
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spelling	oai:doaj.org-article:41946932495348ccba58bbe08a8cf43c2021-12-02T09:01:12ZSublaminar Decompression and Fusion in the Management of Stenotic Lumbar Degenerative Disorders10.21608/esj.2019.5180.10662314-89502314-8969https://doaj.org/article/41946932495348ccba58bbe08a8cf43c2018-10-01T00:00:00Zhttp://www.esj.journals.ekb.eg/article_26433.htmlhttps://doaj.org/toc/2314-8950https://doaj.org/toc/2314-8969Background Data: Lumbar degenerative disorders may result in low back pain, leg pain and limitation of walking distance that can disturb the patients’ life. Several surgical procedures have been used to treat spinal canal stenosis ranging from minimal invasive to extensive decompression and fusion. However, recurrence of symptoms or instability may occur postoperatively. Purpose: To evaluate efficacy and safety of sublaminar decompression and fusion in the management of lumbar degenerative disorders. Study Design: Prospective clinical case study. Patients and Methods: Twenty patients including; 7 central canal stenosis, 5 degenerative disc disease, 4 foraminal and central stenosis, and 4 central stenosis and spondylolisthesis patients were enrolled in this study. All were treated with sublaminar decompression and fusion. Pre- and post-operative clinical evaluation included Visual Analogue scale (VAS) for back and leg pain, Oswestry Disability Index (ODI). Pre- and post-operative measurement of anteroposterior thecal diameter, thecal cross-sectional area, right and left foraminal height were obtained using MRI and CT-scan. The mean follow up duration was 13.85±8.30 (Range, 8-33) months. Results: VAS of leg pain improved from 7.3±1.4 to 2.4±0.9, VAS of the back pain improved from 7.4±0.9 to 2.3±0.5. ODI improved from 76±7.5 to 29.5±8.3. Anteroposterior thecal diameter changed from 10.4±1.4 mm to 14.1±1.1mm. Thecal sac cross sectional area improved from 134.2±19.6 mm2 to 184±20.4 mm2. Right foraminal height changed from 4.4±0.5 mm to 5.4±0.5 mm and left foraminal height changed from 4.2±0.5 mm to 5.2±0.5 mm. The mean time to achieve bone fusion in our series was 8.1 months and the fusion rate was 95%. Conclusion: Sublaminar decompression and fusion is safe and effective procedure in treatment of stenotic degenerative spinal disorders. It achieves high fusion rate without serious complications. (2018ESJ166) Mohammed Khalid Saleh, MD., Mohamed Adel Abdelrazek, MD., Shamel Elgawhary, MD.Egyptian Spine Associationarticlesublaminar decompressionspinal fusiondegenerative disorderslumbar spineNeurology. Diseases of the nervous systemRC346-429ENEgyptian Spine Journal, Vol 28, Iss 1, Pp 32-39 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	sublaminar decompression spinal fusion degenerative disorders lumbar spine Neurology. Diseases of the nervous system RC346-429
spellingShingle	sublaminar decompression spinal fusion degenerative disorders lumbar spine Neurology. Diseases of the nervous system RC346-429 Mohammed Khalid Saleh, MD., Mohamed Adel Abdelrazek, MD., Shamel Elgawhary, MD. Sublaminar Decompression and Fusion in the Management of Stenotic Lumbar Degenerative Disorders
description	Background Data: Lumbar degenerative disorders may result in low back pain, leg pain and limitation of walking distance that can disturb the patients’ life. Several surgical procedures have been used to treat spinal canal stenosis ranging from minimal invasive to extensive decompression and fusion. However, recurrence of symptoms or instability may occur postoperatively. Purpose: To evaluate efficacy and safety of sublaminar decompression and fusion in the management of lumbar degenerative disorders. Study Design: Prospective clinical case study. Patients and Methods: Twenty patients including; 7 central canal stenosis, 5 degenerative disc disease, 4 foraminal and central stenosis, and 4 central stenosis and spondylolisthesis patients were enrolled in this study. All were treated with sublaminar decompression and fusion. Pre- and post-operative clinical evaluation included Visual Analogue scale (VAS) for back and leg pain, Oswestry Disability Index (ODI). Pre- and post-operative measurement of anteroposterior thecal diameter, thecal cross-sectional area, right and left foraminal height were obtained using MRI and CT-scan. The mean follow up duration was 13.85±8.30 (Range, 8-33) months. Results: VAS of leg pain improved from 7.3±1.4 to 2.4±0.9, VAS of the back pain improved from 7.4±0.9 to 2.3±0.5. ODI improved from 76±7.5 to 29.5±8.3. Anteroposterior thecal diameter changed from 10.4±1.4 mm to 14.1±1.1mm. Thecal sac cross sectional area improved from 134.2±19.6 mm2 to 184±20.4 mm2. Right foraminal height changed from 4.4±0.5 mm to 5.4±0.5 mm and left foraminal height changed from 4.2±0.5 mm to 5.2±0.5 mm. The mean time to achieve bone fusion in our series was 8.1 months and the fusion rate was 95%. Conclusion: Sublaminar decompression and fusion is safe and effective procedure in treatment of stenotic degenerative spinal disorders. It achieves high fusion rate without serious complications. (2018ESJ166)
format	article
author	Mohammed Khalid Saleh, MD., Mohamed Adel Abdelrazek, MD., Shamel Elgawhary, MD.
author_facet	Mohammed Khalid Saleh, MD., Mohamed Adel Abdelrazek, MD., Shamel Elgawhary, MD.
author_sort	Mohammed Khalid Saleh, MD.,
title	Sublaminar Decompression and Fusion in the Management of Stenotic Lumbar Degenerative Disorders
title_short	Sublaminar Decompression and Fusion in the Management of Stenotic Lumbar Degenerative Disorders
title_full	Sublaminar Decompression and Fusion in the Management of Stenotic Lumbar Degenerative Disorders
title_fullStr	Sublaminar Decompression and Fusion in the Management of Stenotic Lumbar Degenerative Disorders
title_full_unstemmed	Sublaminar Decompression and Fusion in the Management of Stenotic Lumbar Degenerative Disorders
title_sort	sublaminar decompression and fusion in the management of stenotic lumbar degenerative disorders
publisher	Egyptian Spine Association
publishDate	2018
url	https://doaj.org/article/41946932495348ccba58bbe08a8cf43c
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Sublaminar Decompression and Fusion in the Management of Stenotic Lumbar Degenerative Disorders

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