1,721,300 research outputs found
Surgical management of lumbar spinal stenosis
No full textLumbar stenosis includes various forms of constriction of the spinal canal or the intervertebral foramen. Stenosis may be present in isolation, with or without a disc bulge or herniation, or can be associated with degenerative spondylolisthesis or degenerative scoliosis. This article analyzes the indication for surgery and the methods and outcomes of operative treatment in central, lateral, and foraminal stenosis either isolated or associated with other conditions. The factors that most affect outcome are correct indications for surgery and adequate technique. At present, 70-80% of patients have a satisfactory result from surgery, but the outcome tends to deteriorate in the long term
Results of surgery compared with conservative treatment for lumbar disc herniation
No full textConservative management gives satisfactory results in a high proportion of patients with disc herniation in the course of a few months of treatment onset. This is likely to occur particularly in patients with mild or moderate nerve root compression. Surgical treatment is significantly faster in yielding a satisfactory resolution of symptoms. The chances of a successful outcome are higher in patients with a marked nerve root compression, no or mild back pain, and a short duration of symptoms. The results of surgery often deteriorate in the long and very long term because of recurrence of radicular, and especially low back, pain. In most patients, deterioration is not related strictly to surgery because chances of pain recurrence or worsening with time are similar in the patients treated conservatively and in those who undergo surgery. Microdiscectomy appears to give slightly better results than standard operation in the first few weeks or months after surgery, but no successively. Surgery usually should be undertaken if the patient does not respond after at least 2 months' conservative treatment
Lumbar disc herniation: A new equilibrium is needed between nonoperative and operative treatment
No full text[No abstract available
- …
