PubMed Health⌕ Search

PubMed · 10048061

New nerve root holders during spinal decompression.

Abstract

New nerve root holders have been developed to protect nerve roots and dural sac during spinal bony decompression, especially if it takes place in the region of the lateral recess by means of a high speed air drill. Their design derives from the adaptation of common brain spatulas to the anatomy of the lumbar nerve roots. Their use, together with the contralateral approach (the operative microscopical visualization of the lesion from the side of the patient opposite to it), represents an available method to protect nervous structures from operative injuries without superfluous retraction of them. The contralateral approach permits the visualization of the deepest angles of the lateral recess without withdrawal of lateral parts of the articular facets, important for vertebral stability. In order to achieve satisfactory results without vertebral instrumental stabilization, the holder assists in the drilling procedure to enlarge the periradicular space covering the nerve root and helps avoid undue dural tearing or radicular damage.

Explore related subjects

Keep this discovery

Explore connections, maps & timelines

BibTeXRIS

G Costabile, P Künzler. 1999. New nerve root holders during spinal decompression.. https://doi.org/10.1080/01616412.1999.11740898

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related citations

The evaluation of the surgical management of nerve root compression in patients with low back pain: Part 1: the assessment of outcome.

STUDY DESIGN: This was a prospective study investigating the outcome of decompression surgery using validated measures of outcome. OBJECTIVES: To investigate the outcome of lumbar decompressive surgery in the initial postoperative year period in terms of function, disability, general health, and psychological well-being. SUMMARY OF BACKGROUND DATA: The majority of studies investigating the outcome of lumbar decompression surgery have been retrospective and have not used validated measures of outcome. This limits their interpretation and usefulness. METHODS: Eighty-four patients undergoing lumbar spinal stenosis surgery were recruited into this study. Patients were assessed by use of validated measures of outcome including the Oswestry Disability Index and the Short Form SF-36 General Health Questionnaire before surgery and 6 weeks, 6 months, and 1 year after surgery. RESULTS: A significant reduction in pain (P < 0.001) was observed at the 6-week postoperative stage; this did not change at the subsequent assessment stages. Only some of the SF-36 categories were sensitive to change. The subcategories that were sensitive to change were physical function (P < 0.05), bodily pain (P < 0.001), and social function (P < 0.05). Improvements were observed in these categories at the 6-week and 6-month reviews. A gradual reduction in the Oswestry Disability Index was observed with time, with changes principally being observed between the 6-week and 6-month review and the 6-week and 1-year review stages (P < 0.05). Minimal changes were observed in the psychological assessments with time. The outcome of surgery could not be predicted reliably from psychological, functional, or pain measures. CONCLUSIONS: The visual analogue pain scales, the Oswestry Disability Index, and certain categories of the SF-36 Questionnaire, namely bodily pain and physical and social function, appeared to be the most sensitive outcome measures, with significant improvements occurring at the 6-week and 6-month reviews.

Decompression, Surgical↗

The evaluation of the surgical management of nerve root compression in patients with low back pain: Part 2: patient expectations and satisfaction.

STUDY DESIGN: This was a prospective study investigating patient expectations of and satisfaction with the outcome of decompression surgery. OBJECTIVES: To investigate patient expectations of surgery and short- and long-term satisfaction with the outcome of decompression surgery in terms of pain, function, disability, and general health. SUMMARY OF BACKGROUND DATA: Information is scarce regarding patient-rated expectations of surgery and measures of satisfaction with surgery in terms of specific outcome measures such as pain. METHODS: Eighty-four patients undergoing spinal stenosis surgery were recruited into this study. Before surgery, patients were also asked to rate their expectations in terms of improvement in pain, general health, function, and other such characteristics. In addition, at each postoperative review stage, patients were asked to rate their satisfaction with their improvement in these key outcome measures. RESULTS: The results demonstrated that patients had very high expectations of recovery, particularly in terms of pain and function, and that patients were confident of achieving this recovery (76.8%). Levels of satisfaction, however, varied considerably: 41% of patients were 50% satisfied with the outcome, and 30% were dissatisfied. Most patients felt that they had made the right decision to have surgery, although the surgery had achieved only 43.4% +/- 37.8 of the outcome they had expected. CONCLUSIONS: Examination of patients' expectations of and satisfaction with surgery revealed that patients frequently had unrealistic expectations of their surgery and as a consequence tended to have lower levels of satisfaction.

Decompression, Surgical↗