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Results for “LAMINECTOMY”

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PubMed2006

Thoracic ossified meningioma and osteoporotic burst fracture: treatment with combined vertebroplasty and laminectomy without instrumentation: case report.

Although spinal meningioma is a common benign neoplasm, the ossified variant is rare. No more than 20 sporadic cases were reported in the literature between 1977 and January 2005. Recently, the authors treated a patient with a symptomatic ossified meningioma located in the posterior aspect of T-11 and an associated osteoporotic T-11 burst fracture. The tumor was completely removed by T10-11 laminectomy and transpedicular vertebroplasty was performed. The kyphotic deformity of the T-11 burst fracture was partially reduced and maintained for at least 2 months after vertebroplasty and laminectomy. The clinical presentation and management of this case are reported.

Aged↗
PubMedDate not supplied

Dorsal laminectomy in the treatment of cervical intervertebral disk disease in small dogs: a retrospective study of 30 cases.

Dorsal laminectomy was used to treat 30 dogs with cervical intervertebral disk disease. A variety of breeds were represented, and all animals weighted 15 kg or less. Myelography was utilized to locate each solitary disk herniation. All 30 cases progressed to complete recovery which indicates that dorsal laminectomy may be performed with success in small dogs with intervertebral disk disease.

Animals↗
PubMed1998

[An experimental study of prevention of peridural adhesion following laminectomy].

In order to find an ideal biological material to prevent peridural adhesion following laminectomy, 30 rabbits were used as animal model, in each of which 2 defects with a size of 1 cm x 0.5 cm were made following laminectomy of L3, L5 spine. One of the defects was covered extradurally with chitosan, gelatin foam or PLA membrane respectively, while the other defect was exposed as control. All of these animals were sacrificed on the 2nd, 4th, 6th, 8th and 10th week after operation, and the extradural fibrosis and adhesion of every animal were evaluated by gross observation and histological examinations. It was revealed that in the chitosan and PLA membrane groups, the extradural tissue was smooth without thickening and there was no fibrous proliferation or adhesion in the epidural cavity, and that in the chitosan group, the growth of fibroblast was restrained but the growth of the epithelial cells was promoted significantly, thus, wound healing was rapid. In the control group and gelatin foam group, obvious extradural fibrosis and adhesion were observed and the extradural space had almost disappeared. Therefore, it was concluded that the biodegradable PLA membrane and chitosan were both an ideal material in the prevention of postoperative epidural adhesion.

Animals↗
PubMed1998

[The effect of chitosan in prevention of fibrous scar tissue formation after laminectomy].

OBJECTIVE: To study the effect of chitosan in the prevention of fibrous scar formation in the epidural space after laminectomy. METHOD: Fourty-eight SD rats were used as the animal model. Laminectomy was performed in lumber 1, and the exposed dura was covered with hyaluronate (group A), free fat (group B), chitosan (group C), and saline solution (group D) respectively. At 4, 8 and 12 weeks postoperation, scar formation was observed. RESULT: The results revealed that scar formed in the group D at the fourth week reached a peak at the eighth week and began to soften and constrict at the twelfth week. Sodium hyaluronate and chitosan had a significant efficacy in the prevention of scar formation, but the effect of chitosan was superior to that of sodium hyaluronate. CONCLUSION: The findings of this study indicate that chitosan has a preventive effect on scar tissue formation.

Animals↗
PubMed1999

[Radiculopathy after cervical laminectomy].

OBJECTIVE: To investigate radiculopathy after multilevel laminectomy in patients with cervical compression myelopathy and underlying mechanism. METHODS: We retrospectively reviewed 287 consecutive patients with cervical compression myelopathy treated by multilevel cervical laminectomy and identified 37 patients (12.9%) with postoperative radiculopathy. There were 27 men and 10 women, with an average age of 56 years at time of surgery. The diagnosis was either cervical spondylosis (25 patients) or ossification of the posterior longitudinal ligament (12 patients). RESULTS: Radiculopathy was observed from 4 hours to 6 days after surgery. The most frequent patterns of paralysis were C(5) and C(6) root involvements of the motor-dominant type. All patients showed complete recovery in 2 weeks to 3 years (average, 5.4 months). Follow up results showed that the recovery rate was negatively related to the duration of complete recovery of postoperative radiculopathy (r = -0.832, P < 0.01) and the patients with spondylotic myelopathy had a significantly better clinical recovery rate than those with ossification of the posterior longitudinal ligament (t = 2.960, P < 0.01). CONCLUSIONS: Postoperative radiculopathy is complicated with posterior cervical decompression and associated with tethering effect upon the nerve root. More logical procedures for prevention of postoperative radiculopathy are decompression through an anterior decompressive procedure in conjunction with a spinal fusion, which may achieve stabilization and directly remove all of the anterior spinal cord compression at multiple levels.

Adult↗
PubMed2002

Spinal cord stimulation electrode design: prospective, randomized, controlled trial comparing percutaneous and laminectomy electrodes-part I: technical outcomes.

OBJECTIVE: The clinical use of spinal cord stimulation for treatment of chronic intractable pain has been increasingly successful because of recent technical improvements, particularly the development of multiple-contact electrodes supported by programmable implanted pulse generators. Contemporary electrodes can be placed percutaneously in some cases and require a limited laminectomy in other cases. METHODS: We performed a prospective, randomized, controlled trial comparing two prototypical electrode designs, using a computerized system that allows direct patient interaction and quantitative measurements. A series of 24 patients with chronic lumbosacral pain syndromes first underwent testing with percutaneous four-contact electrodes and then underwent implantation, at the same spinal level, of one of two different electrode configurations; 12 patients received a new percutaneous four-contact electrode of the same design and 12 received an insulated four-contact array, which was implanted via laminectomy. RESULTS: The insulated array performed significantly (P = 0.0005-0.0047) better than the temporary percutaneous electrode for the same patients, according to all three measures tested (ratings of paresthesia coverage of pain, coverage calculated from patient drawings, and amplitudes), at the "usage" amplitude for the three standard bipoles examined. The insulated array also performed significantly (P = 0.0000-0.026) better than the permanent percutaneous electrode in terms of coverage ratings and amplitude requirements. Low back coverage ratings were significantly better for the insulated array than for the temporary percutaneous electrode, and scaled amplitudes necessary for low back coverage were significantly better for the permanent percutaneous electrode than for the temporary electrode. In comparison with the percutaneous temporary electrode, at subjectively identical stimulation intensities, the permanent insulated array required significantly lower amplitude. CONCLUSION: We can immediately infer from these technical data that the use of an insulated array, in comparison with a percutaneous electrode, would double battery life. Extended follow-up monitoring will be required to assess the extent to which the technical advantages we observed for the insulated array might be associated with improved clinical outcomes.

Electric Stimulation Therapy↗
PubMed2003

Spinal morphine for post-operative analgesia after lumbar laminectomy with fusion.

BACKGROUND: Intrathecal administration of preservative free morphine (spinal morphine) provides excellent post-operative analgesia. Since the dura is readily accessible by the surgeon during lumbar spinal surgery, it would be convenient and attractive to administer morphine into the spinal space to provide adequate post-operative analgesia in these patients. METHOD: A prospective randomized controlled study evaluated the post-operative analgesic effect of spinal morphine after lumbar laminectomy with fusion. Forty patients were randomly allocated to two groups, morphine (MO) or normal saline (NSS). Morphine 0.3 mg in normal saline 0.3 ml or normal saline 0.3 ml was injected into the dural sac under direct visualization before closing the wound. An intravenous PCA morphine device was provided for post-operative pain relief. RESULTS: Median visual analog scale (VAS) pain scores were lower in the MO group at 2, 4, 24 and 48 h after surgery (1, 1, 2.75 and 1.5 cm in the MO group vs 4.25, 4.25, 5 and 4 cm in the NSS group) (p < 0.05). The time to first patient control analgesia (PCA) demand was delayed in the MO group (131.7 min vs 29.6 min) (p < 0.05). The cumulative doses of PCA morphine consumption were lower in the MO group in the first 24 h and 24-48 h (13.7 and 15.9 mg vs 41.3 mg and 27.1 mg) (p < 0.001). The incidence of pruritus was higher in the MO group in 24 h and 24-48 h (45%, and 45% vs 5% and 10%) (p < 0.05). The incidence and severity of nausea, vomiting and sedation were not different. No patient developed respiratory depression or postdural puncture headache (PDPH). The patients' satisfaction with post-operative pain management was 100 per cent in the MO group and 85 per cent in the NSS group. CONCLUSION: Spinal morphine improved post-operative pain relief after lumbar laminectomy.

Adult↗
PubMed1992

The results of laminectomy and laminoplasty in cervical myeloradiculopathy.

The authors present the results of laminectomy and laminoplasty in 20 patients with cervical myeloradiculopathy according to the JOA score. Improvement was noted in 74% of the patients after laminoplasty and in 70% of the patients after laminectomy. On the whole decompression is a good method of treatment in this kind of disease.

Adipose Tissue↗
PubMed1992

[Prevention of peridural fibrosis following laminectomy. Apropos of a case of monoradicular paralysis due to an intracanalar hematoma on Gelfoam].

Gelfoam has routinely been used, according to Larroca and Macnab, to prevent scar formation about the dura mater and the nerve roots after laminectomy. We report a case in which postoperative monoradicular paralysis resulted from compression of the thecal cul-de-sac by a hematoma held in place by the Gelfoam. A review of the literature on prevention of adhesions after laminectomy is included.

Aged↗
PubMed2006

[An experimental study on prevention of peridural adhesion after laminectomy].

OBJECTIVE: To explore effective substances and methods for prevention of peridural adhesion. METHODS: Laminectomy was performed on the 5th lumbar segment in 64 rabbits, which were equally divided into 4 groups. The dura mater (12 mm x 6 mm) was exposed. The exposed dura mater was left uncovered in Group A; the exposed dura mater was covered with sodium hyaluronate jel (high molecular weight, 1 ml) in Group B; the lamina repair was performed with the autologous spinous process in Group C; the lamina repair was performed with the sodium hyaluronate jel filling and the autologous spinous process in Group D. The specimens were observed grossly and histologically at 2, 4, 6 and 8 weeks postoperatively. The computed imaging analysis on the epidural adhesion was also performed at 6 weeks postoperatively. RESULTS: 1) The gross anatomical evaluation: Severe peridural adhesion was formed in Group A, less adhesion formed in Groups B and C, but no obvious adhesion formed in Group D. 2) The area percentage of the epidural scar: The area percentage of the epidural scar was 15.89%+/-1.88% and 13.94%+/-1.89% in Groups C and D respectively, which were significantly lower than those in Groups A and B (22.66%+/-2.89% and 20.70%+/-2.82%, P<0. 05). 3) The density of epidural scar: The density of the epidural scars were 42.03%+/-7.36% and 36. 50+/-9.08% in Groups B and D, which were significantly lower than those in Groups A and C (63.73%+/-6.06% and 52. 11%+/- 4.10%, P< 0.05). CONCLUSION: The high molecular weight sodium hyaluronate jel filling combined with the lamina repair using the autologous spinous process has the best preventive effect on the peridural adhesion after laminectomy.

Animals↗
PubMed1989

Anterior spinal tuberculosis: paraplegia following laminectomy.

Of 16 patients with anterior spinal tuberculosis treated in this unit during the period 1979-1984, five presented with neurological complications following laminectomy at another hospital. After the decompressive laminectomy all five patients developed an increasing kyphosis, and four of the five patients had deteriorated neurologically. They were transferred to our unit where the four with neurological deterioration underwent surgical stabilisation. This paper illustrates the dangers of posterior spinal surgery in the presence of anterior disease.

Adult↗
PubMed1989

L4-5 degenerative spondylolisthesis. The results of treatment by decompressive laminectomy without fusion.

The results of the treatment of L4-5 degenerative spondylolisthesis by decompressive laminectomy and partial facetectomy without fusion are presented. Patients who met the following criteria were studied: 1) A slip of at least 10%; 2) No compensation/litigation issues involved; 3) No prior surgery; and 4) Follow-up of at least 18 months. Twenty-four patients with an average follow-up of 34 months (range, 18 to 71 months) are reported. The average preoperative slip measured 7 mm (17%; range, 4-12 mm). Sixteen patients, including all patients less than 60 years of age, underwent preoperative supine lateral flexion-extension radiographs for evaluation of instability. No patient had greater than 2 mm of increase in slip on flexion-extension testing. During decompression, the structural integrity of the pars interarticularis and facet joints are preserved. There were 20 good, three fair, and one poor results. The average postoperative slip measured 8 mm (20%; range, 4-11 mm), and no patient had an increase in slip of greater than 4 mm. In the absence of objective instability on preoperative flexion-extension lateral radiographs in L4-5 degenerative spondylolisthesis, decompressive laminectomy with preservation of the structural integrity of the pars interarticularis and articular processes does not require routine spinal fusion and produced satisfactory clinical results.

Aged↗
PubMed1985

The use of hypnosis in the management of preoperative anxiety and postoperative pain in a patient undergoing laminectomy.

Patients undergoing laminectomy face a variety of concerns both pre- and postoperatively which may affect their emotional state and increase surgical risk. A case study of a laminectomy patient who was taught hypnosis for the control of preoperative anxiety and postoperative pain is presented. The benefits of such hypnotic intervention, as well as the long-term effects of hypnotic intervention on a patient who is in a crisis period are discussed.

Adult↗
PubMedDate not supplied

Long-term evaluation of cervical spine disorders following laminectomy.

The Authors report the results obtained by long-term clinical and radiological evaluation of patients who had undergone cervical multiple bilateral laminectomy to relieve the compression exerted on the cord by different diseases (spondylarthrosis, syringohydromyelia, intramedullary and extramedullary tumours, leptomeningeal cysts and extradural tumours). 98 patients were reviewed, the follow-up ranging from 8 to 24 years (mean 14 years). The results demonstrate that the most severe post-laminectomy changes are recorded in patients with intramedullary lesions and when middle-low cervical spine levels (C4-C7) are affected. The significance of spinal deformities such as kyphosis, spondylolisthesis and swan-neck is also discussed.

Activities of Daily Living↗
PubMed1987

Laminectomy or laminotomy?

After laminectomy in infants and children vertebral deformities often develop. To prevent these the author applied the reanchoring of the dissected arches and ligaments (laminotomy) with success in four children. The details of the procedure and the reanchoring of the vertebral arches are described. This treatment modality should be favourized instead of the destructive laminectomy in this age group in the majority of cases.

Astrocytoma↗
PubMedDate not supplied

[Spinal deformities after laminectomy in children].

The authors discuss the problem of spinal deformity developing after laminectomy in the light of treated case. Clinical observations and literature survey indicate the necessity of orthopaedic consultation before operations impairing stabilization of the spine. Laminectomy, particularly with disturbance of the stability of articular processes is an indication to spondylodesis, and the presence of kyphosis and absence of posterior spinal elements are the primary indication to anterior spondylodesis.

Child↗
PubMed1985

Patient selection for lumbar laminectomy and discectomy with a revised objective rating system.

A revised objective rating system for patient selection for lumbar laminectomy and discectomy in the treatment of disc herniation is presented. Based on the severity of the findings within each of four categories (neurologic signs, root tension signs, myelogram or CT scan findings, and psychosocial environment), numerical scores are derived. A maximum score of 25 points is available in each category, for a total of 100 points. The objective rating score was determined prospectively in 106 patients who were treated by laminectomy for lumbar disc herniation and who were evaluated at least one year after surgery. The rating score was highly predictive of the surgical result. Application of this system for patient selection would reduce reliance on much of the subjective interpretation of physical and radiographic findings. With appropriate patient selection, improved surgical results are possible.

Adolescent↗
PubMed1985

The value of posterior decompression by laminectomy for malignant tumors of the spine.

A 20-year experience of decompression laminectomies is reviewed by studying the results from two teaching hospitals. Seventy percent of the patients received no benefit from the surgery. Thirty percent noted some improvement but their average survival time was limited to 18 weeks. This is not a very profitable procedure when considering associated neurological changes; the patient's longevity should be considered before recommending decompressive laminectomy.

Adolescent↗