Spinal stenosis surgery: Difference between revisions
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==Surgery== | ==Surgery== | ||
If the pain is persistent and does not respond to these measures, surgery is considered to relieve the pressure on the nerves or spinal cord. Surgery is performed on the neck or lower back, depending on the site of the nerve compression. | If the pain is persistent and does not respond to these measures, surgery is considered to relieve the pressure on the nerves or spinal cord. Surgery is performed on the neck or lower back, depending on the site of the nerve compression. | ||
Regarding indications for [[laminectomy]], a complicated, nonrandomized analysis of a [[randomized controlled trial]] of [[laminectomy]]<ref name="pmid17538085">{{cite journal |author=Weinstein JN, Lurie JD, Tosteson TD, ''et al'' |title=Surgical versus nonsurgical treatment for lumbar degenerative spondylolisthesis |journal=N. Engl. J. Med. |volume=356 |issue=22 |pages=2257-70 |year=2007 |pmid=17538085 |doi=10.1056/NEJMoa070302}}</ref>, in patients with: | |||
:"[[neurogenic]] [[claudication]] or [[radicular]] leg pain with associated neurologic signs, spinal stenosis shown on cross-sectional imaging, and degenerative [[spondylolisthesis]] shown on lateral radiographs obtained with the patient in a standing position. The patients had had persistent symptoms for at least 12 weeks and had been confirmed as surgical candidates by their physicians. Patients with adjacent levels of stenosis were eligible; patients with [[spondylolysis]] and isthmic spondylolisthesis were not." | |||
found that patients: | |||
:"treated surgically showed substantially greater improvement in pain and function during a period of 2 years than patients treated nonsurgically." | |||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
Revision as of 19:12, 16 November 2012
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Surgery
If the pain is persistent and does not respond to these measures, surgery is considered to relieve the pressure on the nerves or spinal cord. Surgery is performed on the neck or lower back, depending on the site of the nerve compression.
Regarding indications for laminectomy, a complicated, nonrandomized analysis of a randomized controlled trial of laminectomy[1], in patients with:
- "neurogenic claudication or radicular leg pain with associated neurologic signs, spinal stenosis shown on cross-sectional imaging, and degenerative spondylolisthesis shown on lateral radiographs obtained with the patient in a standing position. The patients had had persistent symptoms for at least 12 weeks and had been confirmed as surgical candidates by their physicians. Patients with adjacent levels of stenosis were eligible; patients with spondylolysis and isthmic spondylolisthesis were not."
found that patients:
- "treated surgically showed substantially greater improvement in pain and function during a period of 2 years than patients treated nonsurgically."
References
- ↑ Weinstein JN, Lurie JD, Tosteson TD; et al. (2007). "Surgical versus nonsurgical treatment for lumbar degenerative spondylolisthesis". N. Engl. J. Med. 356 (22): 2257–70. doi:10.1056/NEJMoa070302. PMID 17538085.