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Results for “LAMINECTOMY”

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At least 235 records · Page 13Linked to original sources

PubMed2005

Anterior cervical osteophyte causing dysphagia as a complication of laminectomy.

Asymptomatic osteophytes of the anterior margins of the cervical vertebral bodies (VB) may occur in 20 - 30% of the population. On rare occasions, dysphagia or dyspnoea may be caused by such cervical osteophytes. We present the case of a 27-year-old woman with progressive dysphagia caused by a voluminous osteophyte secondary to chronic cervical instability after a laminectomy performed 8 years before. Progressive growth of the osteophyte was observed in sequential roentgenograms. As far as we know, this complication of cervical laminectomy has never been reported before. After resection of the osteophyte and arthrodesis of the affected segment the patient was cured.

Adult↗

PubMed1998

Adynamic ileus complicating lumbar laminectomy: a report of two cases.

Adynamic ileus is a well recognized complication of spinal injuries and disease. We report two cases of adynamic ileus affecting both small and large bowel following uncomplicated L4/5 laminectomy. Both patients recovered with conservative treatment, but their hospital stay was prolonged. We have found three other cases in the literature of ileus affecting only the colon following laminectomy at this same level.

Aged↗

PubMed1999

Local anaesthesia for laminectomy surgery.

Neurosurgical patients presenting for laminectomy surgery may have premorbid pathology that either contraindicates general anaesthesia or at least represents a significant risk to the patient. We present a sample case from a series of ten patients in whom laminectomy surgery was performed under local anaesthesia. The mean duration of surgery was 98 minutes and the average dose of lignocaine used was 1.91 mg/kg and, therefore, within safe limits. One patient was converted to a general anaesthetic. We believe that local anaesthesia can offer a safe and satisfactory alternative, in patients who may otherwise be denied surgery. The additional advantage of awake neuro-monitoring, may also reduce the risk of inadvertant spinal cord injury.

Aged↗

PubMed1993

Cervical laminectomy and foraminotomy as surgical treatment of cervical spondylosis: a follow-up study with analysis of failures.

Ninety patients were followed after undergoing multilevel cervical laminectomy for cervical myeloradiculopathy secondary to cervical stenosis. Follow-up data was obtained by chart review and phone interview for all patients; 20% were examined at follow-up as well; 77% of patients were improved, 13% without change, and 10% worse at follow-up. No patients deteriorated in the immediate postoperative period. Greater than 50% of severely disabled patients had an excellent result, and 78% improved somewhat. It is concluded that cervical laminectomy is an effective procedure for treating patients with cervical spondylosis causing myeloradiculopathy. Reasons for failure of this procedure, although rarely identified on follow-up examination, are reviewed and briefly discussed.

Adult↗

PubMed1992

Increased sacroiliac joint uptake after lumbar fusion and/or laminectomy.

Of 753 adult patients undergoing SPECT and planar bone scintigraphy for the evaluation of low back pain, 43 (6%) showed either unilateral or bilateral increased sacroiliac joint (SIJ) uptake. Five of the 58 abnormal joints were only identified with SPECT (9%), whereas 20 of the 58 abnormal joints were much more convincingly demonstrated by SPECT (34%). Fifteen of the 43 patients with increased SIJ uptake had undergone prior lumbar laminectomy and/or spinal fusion. Such spinal surgery can increase impact loading on the SIJ, leading to mechanical overload and sacroiliitis. Degenerative joint disease, trauma, or other benign pathology accounted for the remaining patients with increased SIJ uptake. The authors conclude that for patients with a history of lumbar spinal fusion and/or laminectomy, increased SIJ uptake usually is caused by altered spinal mechanics rather than malignancy or infection.

Adult↗

PubMedDate not supplied

MRI of marked dural sac compression by surgicel in the immediately postoperative period after uncomplicated lumbar laminectomy.

PURPOSE: Our purpose was to determine what represents normal findings on MR examinations of the lumbar spine in the immediately postoperative period following lumbar laminectomy with retained Surgicel. METHOD: MR examinations were performed immediately following lumbar laminectomy in 10 patients referred for symptoms of spinal stenosis. All had Surgicel retained against the dura and were doing well postoperatively without suggestion of adverse symptoms. Images were obtained within 4 days of surgery, most within 24 h. RESULTS: In 9 of 10 patients, severe dural tube compression was present, greater than that evident on preoperative studies. CONCLUSION: Marked spinal canal compression can be a normal finding in the immediately postlaminectomy period in patients with retained Surgicel. There is a lack of correlation between apparent mass effect on the thecal sac and adverse effect. The MR appearance in such instances is not significant in the absence of compressive clinical symptomatology.

Adipose Tissue↗

PubMed1986

The differential utility of the Minnesota Multiphasic Personality Inventory. A predictor of outcome in lumbar laminectomy for disc herniation versus spinal stenosis.

One hundred six patients with disc herniation who underwent lumbar laminectomy and discectomy and 51 patients with spinal stenosis who underwent decompressive lumbar laminectomy were evaluated for surgical outcome at least 1 year postoperatively (mean: 18 months). All had completed the Minnesota Multiphasic Personality Inventory (MMPI) as part of the preoperative evaluation. The Hypochondriasis (Hs), Depression (D), Hysteria (Hy), Psychopathic Deviate (Pd), Psychasthenia (Pt), and Schizophrenia (Sc) scales were found to be predictive of surgical outcome in the herniation group. However, no MMPI scale was related to outcome in the stenosis group. Analysis of covariance showed this fact to be related to the differences in age between the two groups of patients, rather than a result of the differing diagnoses. The MMPI appears to be more useful in predicting surgical outcome in the young and middle-aged adult patient population with disc herniation and is not of predictive utility in the older stenosis population.

Adolescent↗

PubMed1987

Lumbar laminectomy for herniated disc: a prospective controlled comparison with internal fixation fusion.

This is a controlled prospective study on a matched set of patients with herniated lumbar discs. Both groups received the same bilateral lumbar laminectomy and disc excision by the same surgeon. One group had the addition of an intertransverse fusion with internal fixation. Both groups were studied by an independent examiner at an average of 3 years postoperatively for success rate as determined by activity level, medication, subjective and objective evaluation. Both groups had similar age, sex, and occupational characteristics. No patient had prior surgical treatment or chemonucleolysis. Patients with associated lumbar spine problems such as stenosis, instability, or spondylolisthesis were excluded. Each patient had a positive clinical picture for a herniated lumbar disc, as well as a positive myelogram, venogram or computerized tomographic scan. Most had positive electromyograms. All patients received at least 3 months of conservative care. The 38 patients with fusion had a significantly longer mean time to return to work after surgery versus the 31 patients without fusion. Although the general success rate of both groups was 87%, the best results were in the nonfusion group. A total of 29% of nonfusions had excellent results whereas only 11% of the fusion group had excellent results. The conclusion is that fusions are not necessary and give less excellent results in simple laminectomy cases for herniated lumbar disc.

Adult↗

PubMed1989

Cauda equina lesions following fusion in situ and decompressive laminectomy for severe spondylolisthesis. Four case reports.

The authors report four cases of cauda equina lesions following posterior surgery for severe dysplastic spondylolisthesis: three following fusion in situ, and one following decompressive laminectomy. The patients developed urinary retention, saddle anesthesia, and lax anal tone immediately after surgery. The mechanism of the nerve root damage is thought to be mechanical, occurring during decortication before bone grafting. It is recommended that patients should be counseled about the risk of neurologic impairment following decompressive laminectomy or fusion in situ for severe spondylolisthesis.

Adolescent↗

PubMed1990

Risk for occupational low-back injury after lumbar laminectomy for degenerative disc disease.

Thirty-two Postal Service applicants who had undergone laminectomies were classified as low risk for back injury after preplacement examinations and were subsequently hired for employment. Each was compared with six control subjects, who were matched by age, gender, date of hire, and job classification. The odds ratios for occupational back injury with 95% confidence intervals were 5.9 (1.9-18.8) overall and 9.1 (1.5-73.8) for letter carriers. Of subjects, 25% were injured, compared with 6% of controls. The median elapsed time between surgery and hire was 5.9 years for injured subjects and 6.8 years for uninjured subjects. A rank sum test comparing the elapsed times of the two groups was not significant (P = 0.30). Postal workers are at increased risk for back injury after laminectomy. The risk does not appear to decrease with increased time since surgery.

Adult↗

PubMed1991

Vascular complications of lumbar decompression laminectomy and foraminotomy. A unique case and review of the literature.

The possibility of vascular injury should always be kept in mind during lumbar laminectomy. Patients with pre-existing vascular disease are predisposed to injury. Unexplained hypotension is highly suggestive of a vascular catastrophe and is an indication for more detailed examination, sometimes laparotomy. If the patient's clinical condition is stable, consider arteriography. The development of high-output cardiac failure in a patient who has recently undergone lumbar laminectomy is almost diagnostic of traumatic arteriovenous fistula. The best prognosis for recovery of acute vascular interruption occurs with immediate treatment within 24-48 hours. Continued awareness of the possible occurrence of these injuries and familiarity with their various manifestations will facilitate early diagnosis, prompt operative repair, and improved mortality.

Arteries↗

PubMed1991

Lumbar facet fracture as a possible source of pain after lumbar laminectomy.

This study compared 50 patients with lumbar facet fractures and continued pain after lumbar laminectomy with a postlaminectomy control group without facet fractures. Computed tomographic analysis compared variables including direct measurements of bone resection. Average follow-up between surgery and postsurgical computed tomographic examination was 3.2 years. In the fracture group, more than one half of the bone immediately above the flare of the inferior articular process at the level of the laminectomy, measured in a medial to lateral direction, had been resected. No one in the control group had more than one quarter of this bone removed (P = .0001). Lumbar facet fractures may be one cause of late postlaminectomy pain. Caution in resection of a particular area of bone may avoid this problem.

Follow-Up Studies↗

PubMed1994

Postoperative toxic shock syndrome after lumbar laminectomy in a male patient.

OBJECTIVES: Postoperative toxic shock syndrome in a male patient who underwent a lumbar laminectomy has not been reported. This case report identifies a rare, and potentially fatal, postoperative complication. RESULTS: Early diagnosis and aggressive medical management were successful in this patient and are the cornerstone of treatment in toxic shock syndrome. CONCLUSION: Spine surgeons should consider postoperative toxic shock syndrome as a diagnosis in a patient with fever, gastrointestinal symptoms, and hypotension in the presence of a benign-appearing lumbar laminectomy wound.

Diskectomy↗

PubMed2001

Combined laminectomy and thoracoscopic resection of dumbbell-type thoracic cord tumor.

STUDY DESIGN: A study of five patients whose dumbbell or paraspinal tumors of the thoracic spine were managed by using thoracoscopic surgery is reported. OBJECTIVES: To report on the use of combined laminectomy and thoracoscopic resection for the management of dumbbell-type thoracic cord tumor. SUMMARY OF BACKGROUND DATA: Some posterior mediastinal tumors can be resected safely with video-assisted thoracic surgery. However, there are few reports on thoracoscopic resection of dumbbell and paraspinal tumors of the thoracic spine. METHODS: Five patients who received treatment for thoracic spine dumbbell tumors and paraspinal tumors were studied retrospectively. Three patients had dumbbell tumors, and two had paraspinal tumors of the thoracic spine. Preoperative evaluation of each patient included plain chest radiography, magnetic resonance imaging, and computed tomography. All patients underwent total resection by means of a combined posteroanterior approach, with thoracoscopic surgery for dumbbell tumors and thoracoscopic surgery alone for paraspinal tumors. In all patients, a gross total resection was achieved with this approach. All patients were observed for a minimum of 3 years. RESULTS: All patients regained their ability to walk 2 days after surgery, except for one patient who had a hemothorax. A gross total tumor resection, documented by magnetic resonance imaging, was performed on all patients. Follow-up imaging at 6 weeks, 1 year, 2 years, and 3 years after surgery did not show residual tumor or recurrence in any patient. To date, spinal instability has not developed in any patient. CONCLUSIONS: Combined laminectomy and thoracoscopic surgery may be a good alternative method for managing thoracic dumbbell tumors.

Adolescent↗

PubMed2002

Surgical management of lumbar degenerative spinal stenosis with spondylolisthesis via posterior reduction with minimal laminectomy.

Degenerative lumbar spondylolisthesis with spinal stenosis is commonly treated with laminectomy. Recent reports have consistently supported the incremental clinical benefit of associated in situ arthrodesis with or without instrumentation. Resection of the lamina may result in intraoperative dural tear or epidural scar formation. Fifty-six consecutive patients with back pain, neuroclaudication, or both, in addition to degenerative spondylolisthesis with spinal stenosis, underwent a surgical procedure that incorporated fusion after reduction of the spondylolisthesis deformity with preservation of the lamina and the balance of the posterior elements. Clinical records were reviewed and patients interviewed at a mean of 33 months after surgery. Oswestry Disability Index scores were obtained independently at baseline and at a late review. Late imaging was available a mean of 28 months after operation. Clinical and imaging analyses and Oswestry scoring confirmed results comparable to the published outcomes of in situ fusion after formal laminectomy. Resection of the lamina may not be necessary in the treatment of degenerative lumbar spinal stenosis with spondylolisthesis.

Aged↗

PubMed2005

Transient paraparesis after laminectomy for thoracic myelopathy due to ossification of the posterior longitudinal ligament: a case report.

STUDY DESIGN: Case report. OBJECTIVES: We report a case with thoracic myelopathy due to ossification of the posterior longitudinal ligament (OPLL) of the spine, in which neurologic deterioration progressed after laminectomy and was markedly reversed after additional posterior instrumented fusion. SUMMARY OF BACKGROUND DATA: Many different surgical procedures may be used in the treatment of thoracic OPLL. However, the possibility of postoperative paraplegia remains a major risk, and consistent protocols and procedures for surgical correction of thoracic OPLL have not been established. METHODS: The patient was a 53-year-old man with continuous OPLL at T3-T8 that compressed the spinal cord anteriorly. Anterior decompression surgery employing a posterior approach was initiated, but during OPLL extirpation electrophysiologic monitoring of spinal cord activity showed abnormalities. As a result, the procedure was converted to a wide laminectomy. Over the next 4 weeks, kyphosis of the thoracic spine increased and myelopathy worsened, producing severe paraparesis. RESULTS: Four weeks after surgery, posterior instrumented fusion (T1-L1) was performed without correction of the kyphosis. After the fusion, neurologic deficits gradually recovered and the patient was fully recovered after 10 months. At follow-up 15 years after the fusion, no neurologic deterioration was seen despite the presence of residual anterior impingement of spinal cord by OPLL. CONCLUSIONS: The present case suggests that kyphosis and instability are major factors that affect the severity of thoracic myelopathy due to OPLL, and posterior fusion with spinal instrumentation is a safe and effective adjunct procedure for surgical treatment of thoracic OPLL.

Decompression, Surgical↗

PubMed2005

Axial symptoms after cervical laminoplasty with C3 laminectomy compared with conventional C3-C7 laminoplasty: a modified laminoplasty preserving the semispinalis cervicis inserted into axis.

STUDY DESIGN: Results of C4-C7 laminoplasty with C3 laminectomy and C3-C7 laminoplasty were compared. OBJECTIVES: To clarify prospectively whether the modified laminoplasty preserving the semispinalis cervicis inserted into C2 could reduce the axial symptoms compared with conventional laminoplasty reattaching the muscle to C2. SUMMARY OF BACKGROUND DATA: Intraoperative damage of the semispinalis cervicis is relevant to the development of axial symptoms after laminoplasty. In C3-C7 laminoplasty, however, it is difficult to preserve the muscle insertion into C2 while opening the C3 lamina. METHODS: The axial symptoms of 40 patients (Group A) with C4-C7 laminoplasty with C3 laminectomy were compared with those of 16 patients (Group B) with C3-C7 laminoplasty. The cross-sectional areas of the cervical posterior muscles were measured on magnetic resonance images. RESULTS: The number of patients with no postoperative axial symptoms increased (P = 0.035) from 19% to 52.5%, and the number of patients whose symptoms worsened after surgery decreased (P = 0.020) from 50% to 17.5%. The average atrophy rate of cross-sectional area was smaller (P < 0.001) in Group A (2.4%) than in Group B (10.8%). CONCLUSIONS: This method was less invasive to the cervical posterior muscles than C3-C7 laminoplasty. This is an effective procedure for preventing postoperative axial symptoms.

Adult↗

PubMed2006

Efficacy of pneumatic compression stocking prophylaxis in the prevention of deep venous thrombosis and pulmonary embolism following 139 lumbar laminectomies with instrumented fusions.

OBJECTIVE: Low-dose heparin (LDH) regimens reduce the frequency of deep venous thrombosis (DVT) and pulmonary embolism (PE) in spinal surgery but pose a risk of postoperative hemorrhage threatening neurologic function. Pneumatic compression stocking (CS) could provide an alternative means of mechanical prophylaxis alone against DVT and PE and would possibly avoid its hemorrhagic complications. METHODS: The efficacy of CS alone in preventing DVT and PE was evaluated in 139 patients undergoing multilevel lumbar laminectomies (average 3.8 levels) with instrumented fusions (average 1.4 levels). All patients received CS stocking prophylaxis intraoperatively and throughout the average 5-day postoperative course including following ambulation. Doppler screening for DVT was routinely performed 2 days postoperatively. Subsequent Doppler studies or computed tomography angiograms were selectively performed in symptomatic patients with potential DVT/PE. RESULTS: Four (2.8%) patients developed DVT 2-6 days postoperatively and required inferior vena cava (IVC) filters. One of the four had a positive routine screening Doppler study performed the second postoperative day. Two developed DVT the fourth postoperative day. The fourth patient developed DVT 6 days postoperatively but 3 weeks later embolized around the IVC filter. This patient, the only one to develop a PE, tested positive for Factor V Leiden mutation (hypercoagulable syndrome) and remains on long-term warfarin. CONCLUSIONS: Pneumatic compression stocking prophylaxis effectively reduced the incidence of DVT (2.8%) and PE (0.7%) in 139 patients undergoing multilevel lumbar laminectomies with instrumented fusions. These rates compared favorably with those reported in spinal series employing LDH prophylaxis.

Adult↗