Indirect Decompression in Lumbar Degenerative Pathology: Analysis of Imaging Changes at 48 Hours with One-year Follow-up.

IF 1.2 Q3 ORTHOPEDICS
Matias Leonardo Cullari, Juan Pablo Taleb, Lucio Gutierrez, Facundo Martín Aguirre, Santiago Alejandro Aguer, Ruy Lloyd, Glenda Ernst
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引用次数: 0

Abstract

Objectives: Investigate the immediate resonance magnetic image changes undergone by the lumbar canal after indirect decompression and compare them at one-year post-intervention. We also investigate the clinical outcome of indirect decompression at one-year follow-up.

Methods: Imaging changes in patients who underwent indirect lumbar decompression and percutaneous posterior fixation were analyzed with one-year follow-up. Radiographic measurements were performed preoperatively and postoperatively (at one year), and the area of lumbar canal occupation and yellow ligament by nuclear magnetic resonance was compared preoperatively, at 48 hours post-surgery, and at one year. Radiographic measurements included disc height, foraminal height, total lumbar lordosis, and segmental lordosis. The VAS lumbar and lower limb scales and the Oswestry Disability Index (ODI) were used to assess clinical outcomes.

Results: A total of 21 male and 23 female patients underwent indirect decompression at 64 lumbar levels. A significant improvement was observed in the clinical evaluation of all patients' post-surgery (p < 0.001) in all radiographic parameters. There was an immediate increase in the lumbar canal at 48 hours (p < 0.001), which continued to increase at one year post-intervention (p < 0.05). The yellow ligament occupation area decreased at 48 hours (p < 0.001) and continued to decrease until one year (p < 0.01). Four complications were recorded, one of which was a posterior tract infection requiring open decompression.

Conclusion: Indirect decompression for degenerative lumbar disease provided successful clinical outcomes, including indirect expansion of the dural sac at 48 hours post-procedure, with progressive increase in the lumbar canal area at one-year follow-up.

腰椎退行性病理的间接减压:1年随访后48小时影像学变化分析。
目的:探讨间接减压后腰管即刻磁共振成像的变化,并比较干预后1年的差异。我们还调查了间接减压在一年随访中的临床结果。方法:对行间接腰椎减压经皮后路固定术患者的影像学变化进行1年随访分析。术前、术后(1年)行影像学测量,术前、术后48小时、1年行核磁共振腰椎管占位面积、黄韧带面积比较。影像学测量包括椎间盘高度、椎间孔高度、腰椎前凸和节段性前凸。采用VAS腰椎和下肢量表及Oswestry残疾指数(ODI)评估临床结果。结果:共有21名男性和23名女性患者在64个腰椎节段进行了间接减压。所有患者的术后临床评价均有显著改善(p < 0.001)。48小时后腰管立即增加(p < 0.001),干预后1年继续增加(p < 0.05)。黄韧带占据面积在48 h时减少(p < 0.001),并持续减少至1年(p < 0.01)。记录了四个并发症,其中一个是后路感染,需要开放减压。结论:腰椎退行性疾病的间接减压提供了成功的临床结果,包括手术后48小时硬膜囊的间接扩张,一年随访时腰管面积进行性增加。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
2.30
自引率
0.00%
发文量
128
期刊介绍: The Archives of Bone and Joint Surgery (ABJS) aims to encourage a better understanding of all aspects of Orthopedic Sciences. The journal accepts scientific papers including original research, review article, short communication, case report, and letter to the editor in all fields of bone, joint, musculoskeletal surgery and related researches. The Archives of Bone and Joint Surgery (ABJS) will publish papers in all aspects of today`s modern orthopedic sciences including: Arthroscopy, Arthroplasty, Sport Medicine, Reconstruction, Hand and Upper Extremity, Pediatric Orthopedics, Spine, Trauma, Foot and Ankle, Tumor, Joint Rheumatic Disease, Skeletal Imaging, Orthopedic Physical Therapy, Rehabilitation, Orthopedic Basic Sciences (Biomechanics, Biotechnology, Biomaterial..).
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