Stand-Alone Percutaneous Pedicle Screw Lumbar Fixation to Indirectly Decompress the Neural Elements in Spinal Stenosis: A Radiographic Assessment Case Series.
| Autor: | Gazzeri R; Department of Neurosurgeon - Pain Therapy, San Giovanni-Addolorata Hospital, Roma, Lazio, Italy., Panagiotopoulos K; Department of Neurosurgery, San Giovanni-Addolorata Hospital, Roma, Lazio, Italy., Galarza M; Department of Neurosurgery, Virgen de la Arrixaca University Hospital, El Palmar, Murcia, Spain., Leoni MLG; Unit of Interventional and Surgical Pain Management, Guglielmo da Saliceto Hospital, Piacenza, Emilia-Romagna, Italy., Agrillo U; Department of Neurosurgery, San Giovanni-Addolorata Hospital, Roma, Lazio, Italy. |
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| Jazyk: | angličtina |
| Zdroj: | Journal of neurological surgery. Part A, Central European neurosurgery [J Neurol Surg A Cent Eur Neurosurg] 2023 Dec 19. Date of Electronic Publication: 2023 Dec 19. |
| DOI: | 10.1055/s-0043-1777751 |
| Abstrakt: | Background: The ideal surgical treatment of lumbar canal stenosis remains controversial. Although decompressive open surgery has been widely used with good clinical outcome, minimally invasive indirect decompression techniques have been developed to avoid the complications associated with open approaches. The purpose of this study was to evaluate the radiologic outcome and safety of the indirect decompression achieved with stand-alone percutaneous pedicle screw fixation in the surgical treatment of lumbar degenerative pathologies. Methods: Twenty-eight patients presenting with spinal degenerative diseases including concomitant central and/or lateral stenosis were treated with stand-alone percutaneous pedicle screw fixation. Radiographic measurements were made on axial and sagittal magnetic resonance (MR) images, performed before surgery and after a mean follow-up period of 25.2 months. Measurements included spinal canal and foraminal areas, and anteroposterior canal diameter. Results: Percutaneous screw fixation was performed in 35 spinal levels. Measurements on the follow-up MR images showed statistically significant increase in the cross-sectional area of the spinal canal and the neural foramen, from a mean of 88.22 and 61.05 mm 2 preoperatively to 141.52 and 92.18 mm 2 at final follow-up, respectively. The sagittal central canal diameter increased from a mean of 4.9 to 9.1 mm at final follow-up. Visual analog scale (VAS) pain score and Oswestry Disability Index (ODI) both improved significantly after surgery ( p < 0.0001). Conclusion: Stand-alone percutaneous pedicle screw fixation is a safe and effective technique for indirect decompression of the spinal canal and neural foramina in lumbar degenerative diseases. This minimally invasive technique may provide the necessary decompression in cases of common degenerative lumbar disorders with ligamentous stenosis. Competing Interests: None declared. (Thieme. All rights reserved.) |
| Databáze: | MEDLINE |
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