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At least 343 records · Page 19Linked to original sources
PubMed1990

Changes in spinal cord function evaluated by evoked potentials and spinal cord blood flow from a lateral retraction post-cervical laminectomy.

We induced ischemia and stretching by retraction of the spinal cord after laminectomy in 12 anesthetized mongrel adult cats, recorded spinal motor evoked potential (SpMEP) and spinal somatosensory evoked potential (SpSSEP) and determined the spinal cord blood flow (SCBF). The results showed a correlation between progressive deterioration of the function and a decrease in SCBF. Comparing the abnormal findings of both the peak and interpeak latencies in evoked potentials, useful data were more frequently obtained using SpSSEP than SpMEP. Factors involved in their deteriorations seem to be a moderate ischemia by compression, and a stretching by the retraction of the spinal cord. From these results, we conclude that SCBF and SpSSEP are important for monitoring the impulse propagation during retraction of the cervical cord.

Animals↗
PubMedDate not supplied

Subfascial seroma causing compressive myelopathy after cervical dorsal laminectomy.

Dorsal surgical approach to the cervical vertebral canal is indicated for a variety of spinal cord diseases. Compressive myelopathy due to subfascial seroma following dorsal laminectomy has not previously been documented in dogs. We describe neurologic findings, magnetic resonance (MR) imaging characteristics and clinical outcome in a young Rottweiler experiencing this complication after a successful dorsal decompression for treatment of cervical stenotic myelopathy. MR imaging allowed detection of pockets of high signal intensity material on T2-weighted images and low signal intensity in T1-weighted images. Prompt surgical revision and drainage allowed complete recovery.

Animals↗
PubMed1999

Laminectomy for 34 dogs with thoracolumbar intervertebral disc disease and loss of deep pain perception.

The case details and the results of treatment of 34 dogs with thoracolumbar intervertebral disc disease, without deep pain perception, that had been treated by laminectomy and fenestration, are presented. The association of a number of potential prognostic factors with the neurological outcome is examined. Twenty-one dogs (62 per cent) recovered neurological function, seven (21 per cent) failed to recover neurological function and three (9 per cent) developed progressive myelomalacia postoperatively, while three dogs (9 per cent) were euthanized intraoperatively because of diffuse myelomalacia. Twenty of the dogs that recovered neurological function showed a return of deep pain perception within two weeks of decompressive surgery. Statistical analysis showed significant differences in the outcome between dogs that took less than one hour to lose the ability to ambulate and dogs with a longer duration of onset of inability to ambulate. The extent of spinal cord swelling determined by myelography was not found to be a useful prognostic indicator.

Animals↗
PubMed1984

Laminectomy: effects on postoperative technetium and gallium scintigraphy.

Bone scans using Tc-99m diphosphonate were found to become abnormal within 2 weeks after laminectomy in less than half of patients regardless of the extent of the operation. The degree of new uptake equaled that of the sacroiliac joints in only one of 19 patients with a normal preoperative scan. However, the Ga-67 citrate scan usually became abnormal (89%) postoperatively. Thus the Tc-99m bone scan may be helpful in detecting postoperative infection.

Diphosphonates↗
PubMed1992

How to reduce the morbidity of wound closure following extensive and complicated laminectomy and tethered cord surgery.

Prior irradiation and surgery predispose laminectomy wounds to a higher than usual incidence of wound problems. Likewise the tightness or absence of local fascia in the tethered cord patient make wound closure more complicated. To reduce morbidity, i.e., CSF leak or pseudomeningocele formation, specific techniques are required. These methods are outlined below.

Bandages↗
PubMed1996

Major vascular injury during lumbar laminectomy.

Major vascular injury during lumbar laminectomy is an extremely rare complication of one of the commonest surgical procedures performed in orthopaedic and neurosurgical units. Its occurrence may be associated with high morbidity and mortality, particularly if it is not diagnosed in the early stages. Early diagnosis and repair is associated with an improved prognosis in the long term. We illustrate these points with a description of two cases, and discuss the anatomical factors predisposing to these injuries and the importance of angiography in the management and early diagnosis of suspected cases.

Adult↗
PubMed2003

The effect of spinal bupivacaine in combination with either epidural clonidine and/or 0.5% bupivacaine administered at the incision site on postoperative outcome in patients undergoing lumbar laminectomy.

UNLABELLED: Spinal anesthesia has numerous advantages over general anesthesia for patients undergoing lumbar laminectomy and microdisk surgery. In this study, we evaluated the addition of epidural clonidine and/or bupivacaine, injected at the incision site, on postoperative outcome variables in patients undergoing lower spine procedures using spinal anesthesia. One hundred twenty patients having lumbar spine surgery received bupivacaine spinal anesthesia supplemented by 150 microg of epidural clonidine with or without incisional bupivacaine, epidural placebo plus incisional bupivacaine, or placebo with incisional saline. Demographic data, intraoperative hemodynamics, blood loss, pain, nausea, urinary retention, hospital discharge, and other variables were compared by using either analysis of variance or chi(2) analysis. Demographics were similar. IV fluids, blood loss, incidence of intraoperative bradycardia, and hypotension were not different among groups. Postanesthesia care unit pain scores were lower and demand for analgesics was less in patients who received both the clonidine and subcutaneous bupivacaine. Patients who received epidural clonidine also had improved postoperative hemodynamics. Hospital discharge, urinary retention, and other variables were not different. We conclude that epidural clonidine as a supplement to spinal anesthesia produced no perioperative complications and improved postoperative pain and hemodynamic stability in patients undergoing lower spine procedures. IMPLICATIONS: Spinal anesthesia with supplemental epidural clonidine in combination with incision site subcutaneous bupivacaine was evaluated both intra- and postoperatively and compared with spinal anesthesia alone for lower lumbar spine procedures. Both epidural clonidine and subcutaneous incisional bupivacaine, added to spinal anesthesia for lumbar spine surgery, improves pain relief and reduces the need for postoperative opioids with their associated side effects.

Adrenergic alpha-Agonists↗
PubMedDate not supplied

Colonic ileus complicating laminectomy.

Colonic ileus is an unusual form of adynamic ileus that often mimics true intestinal obstruction and that, if not recognized and adequately treated, may be fatal. We have encountered three patients in whom this syndrome followed apparently uncomplicated laminectomy for herniated disc or spinal stenosis. Two of our three patients required abdominal exploration for diagnosis and treatment of the complication. At operation, a large distended colon without volvulus or tumor was found. Cecostomy was performed in both patients. The third patient was treated conservatively. All three patients recovered without sequelae. The pathogenesis of the illness is unknown, but the most widely held view is that ileus results from increased sympathetic activity that inhibits the bowel. Conservative management consisting of correction of any fluid or electrolyte abnormalities, continuous gastric suction via nasogastric tube, and placement of a rectal tube may relieve the symptoms. Patients should, however, be followed carefully and, if distention of the cecum exceeds 12 cm, a decompressive operation is indicated.

Aged↗
PubMed1981

Cerebellar hemorrhage complicating cervical laminectomy.

A case of cerebellar hemorrhage complicating the postoperative course of a patient who had undergone a cervical laminectomy in the sitting position is presented. The drop in cerebrospinal fluid pressure accompanying the procedure is thought to have had some role in the development of the hemorrhage.

Cerebellar Diseases↗
PubMed1983

Do we need to cross match blood for elective laminectomy?

Elective laminectomy cases do not need a routine order for typing and cross matching of blood. Data from the literature and from personal experience in the blood bank of a 580-bed general hospital are presented to support this conclusion. An ABO-Rh type and an antibody screen can safely substitute for routine cross matches for such cases. The use of type and screen rather than cross match allows the blood bank to distribute limited blood resources more efficiently without jeopardizing the patients.

Blood Grouping and Crossmatching↗
PubMed1988

Relief of lumbar canal stenosis using multilevel subarticular fenestrations as an alternative to wide laminectomy: preliminary report.

We describe an operative approach to lumbar canal stenosis which, unlike laminectomy, takes into account the segmental pathology of the disease. At each level involved, a bilateral subarticular fenestration is performed under high magnification. The medial third of each facet joint is first removed with an air-powered drill; then the remaining two-thirds of the joint is undercut with the drill to allow a generous fenestration in the thickened ligamentum flavum and adjacent laminae. All tissue responsible for neural compression is removed, but the spinous processes, interspinous ligaments, and much of the facet joints and laminae are preserved. Spinal stability is maintained and, because tissue disruption is minimized, postoperative discomfort is usually reduced, promoting early mobility and reduced hospital stay. The operation is described in detail, and the results of operation in 32 patients are assessed. The follow-up periods now range from 17 to 58 months. Of 23 patients who presented with neurogenic claudication, 14 (61%) obtained complete relief and 7 (30%) improved significantly. The mean hospital stay was 9 days (range, 4 to 17 days).

Adult↗
PubMed1994

Reduction and stabilization without laminectomy for unstable degenerative spondylolisthesis: a preliminary report.

Fifty-two patients with unstable degenerative spondylolisthesis treated with the "AO internal fixator" and posterolateral fusion were reviewed. The major purpose of this study is to observe whether this pedicle fixation system could adequately decompress the nervous system tissue by the restoration of the spinal canal and, hence, replace the conventional decompressive laminectomy for the treatment of this disease entity. The results were satisfactory, showing that 92% of the patients with radicular pain, 89% of the patients with low back pain, and 86% of the patients with intermittent claudication improved postoperatively. Observing the results, only two groups of patients with unstable degenerative spondylolisthesis are not suitable for this treatment modality. The first group consists of those patients who have a spondylolisthesis with borderline instability. The second group consists of those patients who have a positive Lasèque's sign.

Adult↗
PubMed1988

Retained surgical swab debris in post-laminectomy arachnoiditis and peridural fibrosis.

We examined soft tissue biopsies from 26 patients with symptomatic nerve root fibrosis and arachnoiditis after a previous laminectomy. Dense fibrous connective tissue was found about the nerve roots and in 14 cases (55%) fibrillar foreign material was seen within it. This material had the histochemical characteristics of cotton fibres from swabs and neurosurgical patties. In two other cases nerve root fibrosis was associated with residual radiopaque lipid thought to derive from earlier myelography. Our findings suggest that risks may be associated with the introduction of foreign material into the vertebral canal, and that microscopic fragments of surgical swabs and patties may have a role in the pathogenesis of postoperative periradicular fibrosis.

Adult↗
PubMed1998

Radiculopathy after laminectomy for cervical compression myelopathy.

Postoperative radiculopathy is a complication of posterior cervical decompression associated with tethering of the nerve root. We reviewed retrospectively 287 consecutive patients with cervical compression myelopathy who had been treated by multilevel cervical laminectomy and identified 37 (12.9%) with postoperative radiculopathy. There were 27 men and ten women with a mean age of 56 years at the time of operation. The diagnosis was either cervical spondylosis (25 patients) or ossification of the posterior longitudinal ligament (12 patients). Radiculopathy was observed from four hours to six days after surgery. The most frequent pattern of paralysis was involvement of the C5 and C6 roots of the motor-dominant type. The mean time for recovery was 5.4 months (two weeks to three years). The results at follow-up showed that the rate of motor recovery was negatively related to the duration of complete recovery of postoperative radiculopathy (gamma=-0.832, p < 0.01) and that patients with spondylotic myelopathy had a significantly better rate of clinical recovery than those with ossification of the posterior longitudinal ligament (t=2.960, p < 0.01). Postoperative radiculopathy may be prevented by carrying out an anterior decompression in conjunction with spinal fusion, which will achieve stabilisation and directly remove compression of the cord at multiple levels.

Adult↗
PubMed2006

[Inhibition of peridural fibrosis after laminectomy using biological sheet in rat model].

The prevention of fibrosis after lumbar and thoracic laminectomies by avoiding herniation of muscular tissue was studied using Wistar-EPM rats with a biological membrane made of decorticated bone of bovine material. The rats were sacrificed after eight, sixteen and twenty four weeks and the material was sent to anatomopathological study. This membrane proved to be biocompatible and its efficacy was seen by allowing formation of bone and preventing muscular tissue invasion of the epidural space and avoiding adherences.

Animals↗
PubMed1994

A randomized-control study of active and passive treatments for chronic low back pain following L5 laminectomy.

The professional literature contains relatively few randomized-control studies that have assessed the efficacy of physical therapy approaches to the management of patients with chronic low back pain (CLBP). The purposes of this study were: 1) to investigate the effects of physical agents, joint manipulation, low-tech exercise, and high-tech exercise on objective measures of CLBP; 2) to track the length of CLBP relief; and 3) to determine treatment cost-effectiveness. Two-hundred-fifty subjects (68 females, 182 males; ages 34-51 years) with CLBP following an L5 laminectomy were randomly assigned into five separate groups for a treatment period of 8 weeks. Chronic low back pain status was measured by modified-modified Schober, Cybex Liftask, and Oswestry procedures. Results revealed that: 1) only low-tech and high-tech exercise produced significant improvements (p < .05) in CLBP, 2) the mean period of CLBP relief ranged from 1.6 weeks (control) to 91.4 weeks (low-tech exercise), and 3) low-tech exercise was most cost-effective. It was concluded that: 1) low-tech and high-tech exercise were the only effective treatments for CLBP, 2) low-tech exercise produced the longest period of CLBP relief, and 3) low-tech exercise was the most cost-effective form of treatment. Clinically, low-tech exercise may be the treatment method of choice for the effective management of chronic low back pain.

Adult↗
PubMed1990

Vertebro-PICA aneurysms: midline suboccipital approach and laminectomy of the atlas.

Vertebro-PICA aneurysms represent a particular technical challenge because of the extremely narrow operative field and the presence of numerous vital neural and vascular structures. The lack of exposure still remains the limiting factor in most cases. During the 9-year period from January 1980 to October 1989, 8 vertebro-PICA aneurysms have been treated microsurgically. Of these, 2 underwent a pure suboccipital approach while 6 underwent a midline suboccipital approach with deliberate removal of the arch of the atlas in the park bench position. Seven patients did well and regained full activities while one patient died from complications related to vasospasm with brainstem infarction. One patient developed symptomatic obstructive dilation of the fourth ventricle requiring ventriculo-cisternostomy. The authors recommend the midline suboccipital approach with deliberate C1-laminectomy in ventrolateral decubitus for vertebro-PICA aneurysms. The main advantages are: constant access to the proximal vertebral artery, less medullary retraction in ventrally located aneurysms, improved exposure of the laterobulbar cisterns and the lateromedullary and tonsillar segments of the PICA, thus facilitating dissection of the aneurysm.

Adult↗
PubMed2000

Application of syringosubarachnoid shunt through key-hole laminectomy. Technical note.

The authors describe the key-hole laminectomy technique (KHLT) for application of syringosubarachnoid shunts. This technique was used in 29 patients with noncommunicating syringomyelia. In all cases the shunts were inserted successfully without any peri- or late postoperative complications. The late follow-up magnetic resonance examinations revealed the clear collapse of syrinx in all cases. The authors advocate use of the KHLT because it is associated with less surgery-related trauma, epidural fibrosis, infection, and spinal instability.

Adult↗