Percutaneous ventral decompression for degenerative lumbar spondylolisthesis in medically compromised geriatric patients
Journal Title: Eklem Hastaliklari ve Cerrahisi - Year 2005, Vol 16, Issue 2
Abstract
Objectives: The purpose of this study was to present the surgical technique of percutaneous ventral decompression for degenerative lumbar spondylolisthesis (DLS) in medically compromised geriatric patients and to evaluate its results. Patients and methods: The study included 11 consecutive patients (mean age 67 years; range 51 to 85 years) with DLS accompanied by compressive central canal stenosis and lateral recess stenosis. The affected levels were L3-4 in two patients, and L4-5 in nine patients. All the patients had complaints of bilateral buttock pain, leg pain, and back pain, with significant limitation in ambulation. The mean walking distance before surgery was 150 meters, and the mean preoperative Oswestry Disability Index (ODI) score was 72.2%. Coexisting diseases included diabetes (n=4), cardiac disease (n=5) cerebrovascular accident (n=2), or malignancy (n=2). Percutaneous ventral decompression of the thecal sac was performed under local anesthesia through the posterolateral approach and using endoscopic tools, without violation of the posterior bony structure. The mean follow-up period was 25.1 months (range 11 to 38 months). Results: The mean operation time was 72 minutes (range 50 to 100 min). The mean ODI score decreased to 27.4% (range 4% to 54%) at the final follow-up. All the patients could walk without any difficulty after surgery. Postoperative CT images demonstrated an enlarged spinal canal in all the patients. The only complication was transient quadriceps weakness in one patient. None of the patients showed progression of spondylolisthesis. Conclusion: Percutaneous ventral decompression is a safe and effective minimally invasive method for treating DLS in medically compromised geriatric patients, especially when general anesthesia is not recommended.
Authors and Affiliations
Ho-Yeon Lee, Sang-Ho Lee, Song-Woo Shin
Artroskopik cerrahi ile tedavi edilen ayak bileği sinovyal kondromatozisi: Olgu sunumu
Elli beş yaşında kadın hasta sol ayak bileğinde ağrı, şişlik, hareket kısıtlılığı ve sık ayak bileği burkulması şikayetleriyle başvurdu. Bir yıldır şikayetleri artan hastaya steroid olmayan antienflamatuvar tedavi uygula...
Migrasyonlu disk herniasyonunun perkütan endoskopik lomber diskektomi ile<br /> tedavisinde yeni cerrahi teknikler
Amaç: Perkütan endoskopik lomber diskektomi (PELD) protrude diskler için iyi sonuçlar sağlasa da, migrasyonlu disklerde çeşitli sorunlar ortaya çıkmaktadır. Bu çalışmada, migrasyonlu diskler için geliştirilen iki yeni PE...
Shoulder hemiarthroplasty for the treatment of three- and four-part fractures<br /> of the proximal humerus
bjectives: We evaluated the results of hemiarthroplasty in the treatment of three- or four-part proximal humeral fractures. Patients and methods: Eleven patients (8 females, 3 males; mean age 64 years; range 38 to 75 ye...
Posterior longitudinal ligamanın servikal ossifikasyonunun tedavisinde<br /> lazer-yardımlı mikrocerrahi teknikleri
Objectives: Ossification of the posterior longitudinal ligament (OPLL) is one of the common causes of cervical myelopathy in Asian countries. The purpose of this study was to evaluate the efficacy of CO2 laser-assisted m...
Malleol kırıklarında transfiksasyon vidasının çıkarılması veya bırakılmasının fonksiyonel sonuçlara etkisi
Amaç: Malleol kırığı nedeniyle cerrahi uygulanmış hastalarda transfiksasyon vidasının çıkarılmasının fonksiyonel sonuçlar üzerindeki etkisi değerlendirildi ve ameliyat sonrasında vidanın çıkarılmadığı hastalarla karşılaş...