Degenerative Lumbar Spine Stenosis Consensus Conference: the Italian job. Recommendations of the Spinal Section of the Italian Society of Neurosurgery.

Autor:	Costa F; Department of Neurosurgery, Humanitas Clinical and Research Center-IRCCS, Rozzano, Milan, Italy - francesco.costa@humanitas.it.; Department of Biomedical Sceinces, Humanitas University, Milan, Italy - francesco.costa@humanitas.it., Innocenzi G; Department of Neurosurgery, IRCCS NEUROMED, Pozzilli, Isernia, Italy., Guida F; Department of Neurosurgery, Ospedale dell'Angelo, Mestre, Venice, Italy., Agrillo U; Department of Neurosurgery, San Giovanni-Addolorata Hospital, Rome, Italy., Barbagallo G; Department of Neurosurgery, University of Catania, Catania, Italy., Bocchetti A; Santa Maria delle Grazie Hospital, ASL Napoli 2 Nord, Pozzuoli, Naples, Italy., Bongetta D; Department of Neurosurgery, ASST Fatebenefratelli Sacco, Milan, Italy., Cappelletto B; Section of Spinal Column and Spinal Cord Surgery and Spinal Unit, Santa Maria della Misericordia University Hospital, Udine, Italy., Certo F; Department of Neurosurgery, University of Catania, Catania, Italy., Cimatti M; N.E.S.M.O.S Department, Faculty of Medicine and Psychology, Sapienza University, Rome, Italy., Cioffi V; Santa Maria delle Grazie Hospital, ASL Napoli 2 Nord, Pozzuoli, Naples, Italy., Dobran M; Department of Neurosurgery, Marche Polytechnic University, Ancona, Italy., Domenicucci M; Department of Neurology and Psychiatry, Neurosurgery, Polo Pontino, Sapienza University, Rome, Italy., Guizzardi G; Spinal Section, Centro Chirurgico Toscano, Arezzo, Italy., Guizzardi G; Division of Neurosurgery, Federico II University, Naples, Italy., Landi A; Division of Neurosurgery and Spinal Surgery, San Carlo di Nancy Hospital, Rome, Italy., Marotta N; Division of Neurosurgery and Spinal Surgery, San Carlo di Nancy Hospital, Rome, Italy., Marzetti F; Neurosurgery Division, Umberto I University Hospital, Sapienza University, Rome, Italy., Montano N; Institute of Neurosurgery, Catholic University of Rome, Rome, Italy., Anania CD; Department of Neurosurgery, Humanitas Clinical and Research Center-IRCCS, Rozzano, Milan, Italy., Nina P; Unit of Neurosurgery, San Giovanni Bosco Hospital, Naples, Italy., Quaglietta P; Unit of Neurosurgery, General Hospital of Cosenza, Cosenza, Italy., Rispoli R; Section of Spinal Column and Spinal Cord Surgery and Spinal Unit, Santa Maria della Misericordia University Hospital, Udine, Italy., Somma T; Division of Neurosurgery, Federico II University, Naples, Italy., Squillante E; Unit of Neurosurgery, San Giovanni Bosco Hospital, Naples, Italy., Visocchi M; Institute of Neurosurgery, Catholic University of Rome, Rome, Italy., Vitali M; Unit of Neurosurgery, SS. Antonio e Biagio e Cesare Arrigo Hospital, Alessandria, Italy., Vitiello V; Unit of Neurosurgery, San Giovanni Bosco Hospital, Naples, Italy.
Jazyk:	angličtina
Zdroj:	Journal of neurosurgical sciences [J Neurosurg Sci] 2021 Apr; Vol. 65 (2), pp. 91-100. Date of Electronic Publication: 2020 Sep 24.
DOI:	10.23736/S0390-5616.20.05042-0
Abstrakt:	In the modern era evidence-based medicine, guidelines and recommendations represent a key-point of daily activity. The Spinal Section of the Italian Society of Neurosurgery introduced some recommendations regarding Degenerative Lumbar Spine Stenosis based on those of the Spine Committee of World Federation of Neurosurgical Societies, revising them on the basis of Italian common practice. In June 2019, a Committee of 21 spine surgeons met in Rome to validate the recommendations of the WFNS. Furthermore, they decided to review the ones that did not reach a consensus to create Italian Recommendations on Degenerative Lumbar Spine Stenosis. A literature review of the last ten years was performed and the statements were voted using the Delphi method. Forty-one statements were discussed, and 7 statements were voted again to reach a consensus with respect to those of the WFNS. A total of 40 statements reached a consensus, of which 36 reached a positive consensus and 4 a negative consensus, while no consensus was reached in 1 case. Conservative multimodal therapy, tailored on the patient, is a reasonable and effective first option choice for the treatment of LSS patients with tolerable moderate symptoms. Surgical treatment is reserved for symptomatic patients non-responding to conservative treatment or with neurological deficits. The best surgical technique to use depends on personal experience; modern MISS techniques are equivalent to open decompressive surgery with some advantages and higher cost-effectiveness. Fusion surgery and mobility preserving surgery only have a marginal role in the treatment of DLSS without instability.
Databáze:	MEDLINE
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