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- W2507777213 abstract "Background: Symptomatic lumbar canal stenosis (LCS) usually responds well to surgery. However, in a subset of patients symptoms recur after variable periods of time. Aims: The aim of this study was to identify subset of patients having same segment early recurrence (recurrence <2 years) in surgery of LCS and the role of dissectomy in causing it. Materials And Methods: A prospective analysis of 100 patients who were operated for LCS from 2013 to 2015. All patients were followed up for atleast 2 years. Inclusion Criteria: Symptomatic LCS with or without Grade 1 fixed listhesis. Exclusion Criteria: LCS associated with Listhesis of grade 2 or more, LCS with mobile listhesis of any grade, presence of degenerative scoliosis and follow up more than 2 years. Based on type of surgical procedure performed initially patients were divided into 3 categories. CATEGORY-1 Decompression via laminectomy and foraminotomy. CATEGORY-2 Category 1 along with dissectomy. CATEGORY-3 Category 2 with TLIF combined. Redo surgical options included 1. Excision of scar and foraminotomy. 2. Excision of scar and pedicle screw rod fixation. 3. Only pedicle screw rod fixation with distraction. Results:In category 1 out of 5 patients (9.09%) developed recurrence, in category 2 out of 9 patients (22.5%) developed recurrence (p<0.0001). Conclusions: The strongest predictor of early recurrence is dissectomy combined with decompression. Excision of disc material leads to vertebral settling resulting in loss of height of foraminal space. So in surgery for LCS, dissectomy should only be done if frank herniation is present causing significant compression. When dissectomy is done it should always be supplemented with stand alone TLIF. In redosurgery, excision of scar tissue leads to major dural tears. Pedicle screw rod fixation with distraction is an excellent option in these cases as it leads to restoration of foraminal height." @default.
- W2507777213 created "2016-09-16" @default.
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- W2507777213 date "2016-08-01" @default.
- W2507777213 modified "2023-10-02" @default.
- W2507777213 title "Same Segment Early Recurrence in Surgery of Lumbar Canal Stenosis- Role of Dissectomy" @default.
- W2507777213 cites W1974941555 @default.
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- W2507777213 doi "https://doi.org/10.9790/0853-1508023440" @default.
- W2507777213 hasPublicationYear "2016" @default.
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