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At least 397 records · Page 22Linked to original sources
PubMed1980

Recurrent disc prolapse as a cause of recurrent pain after laminectomy for lumbar disc lesions.

Recurrent disc lesions occur in about 19 percent of patients having a primary laminectomy and occurring in just under half (46 percent) of those suffering recurrent pain. The clinical features are similar to those of a primary disc lesion. The most likely site (two out of three) is the same disc level as before, with an equal probability of involving the previous or its opposite side. Re-operation appears to carry a good prognosis, with 80 percent good results, while with conservative treatment 45 percent will settle down in less than three months.

Humans↗
PubMed1982

Central cord syndrome as a delayed postoperative complication of decompressive laminectomy.

We report five cases of a central cord syndrome that appeared as a delayed surgical complication several days after decompressive laminectomy with the patient in the sitting position. Some episode of abnormal positioning of the neck or hypotension seems to have triggered the central cord syndrome. The patients improved slowly, but did not return to their immediate postoperative status. This complication probably can be avoided with careful mobilization after operation, with the avoidance of hypotension, and with the use of a firm collar during the first few postoperative days.

Aged↗
PubMedDate not supplied

[Treatment of complicated thoracic and lumbar spinal injuries and prevention of the sequelae of laminectomy].

The operation of choice in complicated trauma of the vertebral column with compression of the spinal cord (especially in the thoracic and the thoracicolumbar segments) is laminectomy (as the first stage of the intervention) performed in the earliest period. It is obligatory to conduct extensive inspection of the spinal cord and its roots, perform its anterior and posterior decompression and subsequent reliable stabilization of the spine, which may prevent recurrent compressions of the spinal cord in the residual period.

Adult↗
PubMed1980

Vascular injuries during lumbar laminectomy.

Vascular injury during lumbar laminectomy is an uncommon event. It is most often secondary to a biting instrument, such as a pituitary rongeur. Its diagnosis must be made rapidly in order to save the patient from exsanguination. This is well within the province of the general surgeon, who should be prepared to treat it at any time.

Adolescent↗
PubMedDate not supplied

Spondylolisthesis: treatment by laminectomy and posterior interbody fusion.

Spondylolisthesis is a hereditary anomaly of the spine, often associated with intractable pain in the back and lower extremities. The diagnosis is commonplace. Approximately 5% to 7% of the population in the United States has the anomaly. This percentage varies with country and race. In patients who seek medical aid for symptoms of low back pain, 10% will have a pars defect. Laminectomy of the entire separate neural arch and a posterior interbody fusion is a superior operation for spondylolisthesis. It is a difficult operation, requiring a high degree of technical skill, but when properly performed, it is possible to attain a more rapid recovery with a lower morbidity and higher percentage of permanent cures.

Adolescent↗
PubMed1995

[Spinal anesthesia for disk herniation and lumbar laminectomy. Apropos of 77 cases].

77 spinal anaesthesias were performed over a 9-month period for surgical cure of herniated discs or lumbar laminectomy in knee-chest posture. Operating conditions were good or excellent in 66 patients (85.7%). Better results were obtained with lidocaine 5% than with bupivacaine 0.5% (both with fentanyl). Nine partial or total failures were recorded, eight of which in patients who underwent a preoperative radiculography and whose spinal anaesthesia was performed with bupivacaine. A likely explanation of these failures might be a leakage of local anaesthetic into the epidural space distended by radiopaque material. No intra or postoperative complications other than six transient hypotensions occurred. Despite of certain advantages, spinal anaesthesia cannot be recommended in all cases, particularly in patients at risk or if surgical time might be protracted. On the other way, ever possible failure obliges to inform preoperatively the patients that general anaesthesia cannot be excluded.

Aged↗
PubMed1994

Seventeen level laminectomy for extensive spinal epidural abscess: case report and review.

Several studies have suggested that non-operative treatment be employed for spinal epidural abscesses involving a considerable length of the vertebral column. The reasons for this have not been clearly stated in the literature, however, nor has the critical number of vertebral levels been specified. Presumably, this is related to the morbidity of extensive laminectomy, but we began to question this assumption because of advances in surgical instrumentation combined with frequent reports of irreversible disease progression while on appropriate antibiotics. In this article, we present a case of an extensive spinal epidural abscess managed surgically with no associated morbidity. In addition, we present a review of the literature concerning spinal epidural abscess.

Abscess↗
PubMed1994

[Treatment of lumbar spinal stenosis with partial laminectomy and canal enlargement].

Thirty-eight patients with lumbar spinal stenosis were treated by partial laminectomy, incision of ligmental flava and canal enlargement. According to the pathological characteristic of lumbar spinal stenosis, both decompression and stability of the lumbar spine would be achieved by limited surgical treatment to the pathological segment and removing of any pathological factors. The average time for follow-up is 14 months. The excellent rate is 89.5%. The technique of the operation was also described and discussed.

Adult↗
PubMedDate not supplied

Migration of luque rods through a laminectomy defect causing spinal cord compression.

Internal fixation of traumatic spinal injuries has been associated with spinal canal stenosis, spinal cord compression, and nerve root impingement. We present a case of spinal cord/cauda equina compression due to migration of intact, anchored thoracolumbar Luque rods into the spinal canal through a laminectomy defect, leading to neurologic complications 10 years after the original operation.

Adult↗
PubMed1993

[An arteriovenous fistula following laminectomy--sonographic diagnosis].

In a 36-year-old woman, 10 years after laminectomy, a tentative diagnosis of arteriovenous shunt between the right iliac artery and vein, a rare complication of this procedure, was made on the basis of ultrasonographic findings. The signs consisted of dilatation of the iliac vein and of the inferior vena cava, a vascular bruit and tactile fremitus in the abdomen. In addition, cardiac enlargement and slight tricuspid and mitral incompetence in the absence of cardiac insufficiency were noted. After angiographic verification of the diagnosis the anomaly was corrected surgically.

Adult↗
PubMed1996

Laparoscopic L5-S1 diskectomy: a cost-effective, minimally invasive general surgery--neurosurgery team alternative to laminectomy.

Laparoscopic L5-S1 diskectomy (LLD) is a promising new technique for managing disabling pain from herniated lumbar disks. It is unknown, however, whether the clinical results of LLD are superior to those of traditional laminectomy (LAM). This study was undertaken, therefore, in order to compare LLD and LAM in the management of L5-S1 disk herniation unresponsive to conservative treatment measures. Clinical records of 22 patients who underwent 23 LLD procedures and of 23 LAM patients were reviewed with respect to demographics and median age, operative blood loss, operative time, hospital stay, and time of rehabilitation to work/normal activity, as well as postoperative morbidity, recurrent symptoms, long-term functional status, and inhospital patient charges. Two LLD patients had undergone LAM previously, and one had a percutaneous microdiskectomy. All LLD patients had relief of disk pain immediately after surgery. Morbidity after LLD included transient brachial plexus neuropraxia (1), urinary retention (1), and rectus hematoma (1). No LAM complications were reported. Among LLD patients, compared with LAM, median age (34.5 years versus 40 years), estimated blood loss (12 mL versus 68 mL), hospital length of stay (1 day versus 3 days), time to normal activity (17 days versus 79 days) and mean inhospital patient charges ($5,737 +/- 283 versus $7,762 +/- 662) were reduced significantly (P < 0.05). LLD operating time was significantly longer than LAM (210 versus 160 minutes median, P < 0.01). With a median follow-up time of 11.0 months (range, 2 to 23 months) all LLD patients had returned to normal activity, whereas 7 of the LAM group (30%) remained disabled (P < 0.01). Sixty-eight per cent of LLD patients were pain-free during follow-up, compared with 39 per cent of the LAM group (P < 0.05). Sixty-four per cent of LLD patients and 57 per cent of the LAM group needed postoperatively physical therapy. One LLD and 4 LAM patients required reoperation, by LLD and LAM, respectively, for recurrent disk herniation. LLD is a safe, cost-effective, minimally invasive operation for managing disabling L5-S1 disk herniation. Compared with LAM, LLD reduces blood loss, length of stay, rehabilitation time, and patient charges, and improves long-term functional and pain-free status. LLD should be considered as an alternative to LAM for patients with herniated L5-S1 intervertebral disks unresponsive to conservative management.

Adult↗
PubMed1996

Dorsal laminectomy in the adult mouse: a model for nervous system research.

Animal strains with specific genetic mutations can serve as powerful tools to study normal and pathologic cellular and molecular processes. The mammalian species with the largest number of known genetic mutations is the mouse. In spinal cord research, mice have not been used as extensively as other species because of the difficulty in accessing and manipulating their spinal cord. We describe the technique of exposing and manipulating the spinal cord of normal mice and of mice with the severe combined immunodeficiency (scid) mutation. Surgical outcome and complications are discussed. We conclude that dorsal laminectomy with subsequent access and manipulation of the spinal cord and its roots can be accomplished consistently with practice.

Animals↗
PubMed1996

Efficacy of closed wound suction drainage after single-level lumbar laminectomy.

The use of closed suction drainage after spinal surgery remains controversial. The purpose of this study was to determine the indications for closed suction drainage after single-level lumbar surgery. Two hundred patients who were scheduled to undergo single-level lumbar surgery without fusion were prospectively randomized into two groups. One group had a closed wound suction drain placed deep to the lumbodorsal fascia before routine closure, whereas the second group had no drain placed. Hemostasis was achieved in all patients before the surgeon had knowledge of the randomization outcome. All drains were removed on the 2nd postoperative day, and the amount of drainage was recorded. After surgery, the patients were evaluated for signs and symptoms of continued wound drainage, hematoma/seroma formation, and/or infection as well as evidence of an acquired neurologic deficit. One hundred three patients had a drain placed before closure and two patients developed postoperative wound infection, both of which were successfully treated with orally administered antibiotics. Of the 97 patients who had no drain placed after the surgical procedure, one patient developed a postoperative wound infection that was treated with surgical incision and drainage, as well as intravenously administered antibiotics. Statistical analysis revealed that the presence or absence of a drain did not affect the postoperative infection rate. No new neurologic deficits occurred in any postoperative patient. The use of drains in single-level lumbar laminectomy without fusion did not affect patient outcome. There was no significant difference in the rate of infection or wound healing and no patient developed a postoperative neurologic deficit.

Adult↗
PubMed1989

Percutaneous lumbar discectomy. An alternative to lumbar laminectomy.

Percutaneous lumbar discectomy demonstrates how technology is improving medicine. The procedure allows the patient to have lumbar disc surgery without all the risks involved with open back surgery. It is relatively noninvasive, decreases operating time, and allows use of local anesthesia which reduces chances of infection, postoperative complications, and cost. With proper patient selection and correct surgical technique, percutaneous lumbar discectomy has the potential to be an alternative to laminectomy for uncomplicated herniated disc surgery.

Humans↗
PubMed1998

Medical case management after laminectomy or craniotomy: do all patients benefit from admission to the intensive care unit?

To define severity of illness to identify most effectively patients for whom admission to the intensive care unit (ICU) is unnecessary, the authors performed a retrospective cost-effectiveness analysis. The authors studied the records of 113 patients who were admitted to the ICU after undergoing laminectomy (or other spinal cord surgery) or craniotomy for removal of neoplasm; the Acute Physiology and Chronic Health Evaluation III prognostic system had identified these patients as having a 10% or less risk of requiring intervention while in the ICU. No patient required active intervention during a mean stay of 3.26 days in the ICU. Combined use of a "step-down" postoperative care unit and ICU can optimize allocation of medical resources while providing high-quality care for some neurosurgical patients who are at low risk of requiring postoperative intervention.

Journal Article↗
PubMed1983

Iliac arteriovenous fistula complicating lumbar laminectomy.

An iliac arteriovenous fistula may rarely complicate lumbar laminectomy, particularly at the L4-L5 level. We present such a complication in a 45-year-old man who presented in our institution with a postlaminectomy iliac arteriovenous fistula and severe congestive heart failure. Repair of the fistulous orifice and tubular reconstruction of the iliac artery were successfully performed.

Journal Article↗
PubMed1988

[Recalibration of the lumbar canal, an alternative to laminectomy in the treatment of lumbar canal stenosis].

A technique is described for widening the lumbar vertebral canal in the treatment of lumbar stenosis. This method, which preserves part of the posterior arches, has the aim of avoiding the instability which accompanies extensive laminectomies of the whole lumbar spine. The preservation of the posterior arches allows a ligamentoplasty to be made with dacron in stable spines and a combined fusion with internal fixation applied to the posterior arches to be made in cases of spondylolisthesis. The results of a prospective series of 32 patients have confirmed the effectiveness of the method both on the stenosis and on the post-operative spinal stability.

Adult↗