Talk:Laminectomy

note
I feel that the results section is especially lacking. As medical articles are used often by patients I feel this section is incomplete, contradictory to the general tone, and at worst alarming. I am by no means a medical expert nor am I a patient. I feel that this section should be removed or simplified until it can be completed. (75.83.36.180 (talk) 18:52, 30 August 2009 (UTC)mini-bot)

I am placing a running list of references with abstracts on this talk page, for all of our use. I will put references in parenthesis as I work on text, in the article, and would appreciate it if those that can would format them properly. Thank you. DrSculerati (talk) 00:59, 17 May2008 (UTC) I'm actively working on the article to correct it's current lack of references. I'd appreciate it if the list below was left in place so that I (and others) may use it for that purpose. DrSculerati (talk) 14:10, 17 May 2008 (UTC)

'''Barami K. Dagnew E. Endoscope-assisted posterior approach for the resection of ventral intradural spinal cord tumors: report of two cases.[Case Reports. Journal Article] Minimally Invasive Neurosurgery. 50(6):370-3, 2007 Dec.''' (We report our experience with the removal of ventral intradural spinal tumors through a posterior approach with the assistance of an endoscope. The endoscope allowed us to remove the tumor with minimal retraction of the spinal cord and to inspect for involvement of structures that were difficult to visualize with the microscope. Moreover, it obviated the use of a more involved anterior approach. This is the second report of the utilization of the endoscope for removal of intradural spinal cord tumors. Our data are discussed in the context of prior reported morphometric studies involving the spinal cord and expand the indications for the endoscope.)

'''McGirt MJ. Chaichana KL. Atiba A. Bydon A. Witham TF. Yao KC. Jallo GI. Incidence of spinal deformity after resection of intramedullary spinal cord tumors in children who underwent laminectomy compared with laminoplasty. [Comparative Study. Journal Article] Journal of Neurosurgery. Pediatrics.. 1(1):57-62, 2008 Jan.''' (Abstract:OBJECT: Gross-total resection of pediatric intramedullary spinal cord tumor (IMSCT) can be achieved in the majority of cases while preserving long-term neurological function. Nevertheless, postoperative progressive spinal deformity often complicates functional outcome years after surgery. The authors set out to determine whether laminoplasty in comparison with laminectomy has reduced the incidence of subsequent spinal deformity requiring fusion after IMSCT resection at their institution. METHODS: The first 144 consecutive patients undergoing resection of IMSCTs at a single institution underwent laminectomy with preservation of facet joints. The next 20 consecutive patients presenting for resection of IMSCTs underwent osteoplastic laminotomy regardless of patient or tumor characteristics. All patients were followed up with telephone interviews corroborated by medical records for the following outcomes: 1) neurological and functional status (modified McCormick Scale [MMS] score and Karnofsky Performance Scale [KPS] score); and 2) development of progressive spinal deformity requiring fusion. The incidence of progressive spinal deformity and the long-term neurological function were compared between the laminectomy and osteoplastic laminotomy cohorts. The means are expressed +/- the standard deviation. RESULTS: Overall, the patients' mean age was 8.6 +/- 5 years, and they presented with median MMS scores of 2 (interquartile range [IQR] 2-4). A > 95% resection was achieved in 125 cases (76%). There were no differences (p > 0.10) between patients treated with osteoplastic laminotomy and those treated with laminectomy in terms of the following characteristics: age; sex; duration of symptoms; location of tumor; incidence of preoperative scoliosis (Cobb angle > 10 degrees : 7 [35%] with laminoplasty compared with 49 [34%] with laminectomy); involvement of the cervicothoracic junction (7 [35%] compared with 57 [40%]); thoracolumbar junction (4 [20%] compared with 36 [25%]); tumor size; extent of resection; radiation therapy; histopathological findings; or mean operative spinal levels (7.5 +/- 2 compared with 7.5 +/- 3). Nevertheless, patients who underwent osteoplastic laminotomy had better median preoperative MMS scores than those treated with laminectomy (2 [IQR 2-2] compared with 2 [IQR 2-4]; p = 0.04). A median of 3.5 years (IQR 1-7 years) after surgery, only 1 patient (5%) in the osteoplastic laminotomy cohort required fusion for progressive spinal deformity, compared with 43 (30%) in the laminectomy cohort (p = 0.027). Adjusting for the inter-cohort difference in preoperative MMS scores, osteoplastic laminotomy was associated with a 7-fold reduction in the odds of subsequent fusion for progressive spinal deformity (odds ratio 0.13, 95% confidence interval 0.02-1.00; p = 0.05). The median MMS and KPS scores were similar between patients who underwent osteoplastic laminotomy and those in whom laminectomy was performed (MMS Score 2 [IQR 2-3] for laminotomy compared with 2 [IQR 2-4] for laminectomy, p = 0.54; KPS Score 90 [IQR 70-100] for laminotomy compared with 90 [IQR 80-90] for laminectomy, p = 0.545) at a median of 3.5 years after surgery. CONCLUSIONS: In the authors' experience, osteoplastic laminotomy for the resection of IMSCT in children was associated with a decreased incidence of progressive spinal deformity requiring fusion but did not affect long-term functional outcome. Laminoplasty used for pediatric IMSCT resection may decrease the incidence of progressive spinal deformity requiring subsequent spinal stabilization in some patients.)  Katz JN, Lipson SJ, Chang LC, et al. Seven- to ten-year outcome of decompressive surgery for degenerative lumbar spinal stenosis. Spine 1996;21:92–8.(Abstract- Study Design: Retrospective review and prospective follow-up of 88 patients who had decompressive laminectomy with or without fusion from 1983 to 1986. Objective: To determine the 7- to 10-year outcome of surgery for degenerative lumbar spinal stenosis. Summary of Background Data: There is limited information on the impact of surgery for lumbar spinal stenosis on symptoms, walking ability, and satisfaction, as well as reoperation. Methods: Patients completed standardized questionnaires in 1993 that included items about reoperations, back pain, leg pain, walking capacity, and satisfaction with surgery. Associations between preoperative demographic and clinical variables and outcomes 7 to 10 years after surgery were evaluated in univariate and multivariate analyses.Results: Average preoperative age was 69 years and eight patients received fusion. Of 88 patients in the original cohort, 20 (23%) were deceased and 20 (23%) had undergone reoperation by 7- to 10-year follow-up. Fifty-five patients answered questionnaires. Average duration of follow-up was 8.1 years. Thirty-three percent of the respondents had severe back pain at followup, 53% were unable to walk two blocks, and 75% were satisfied with the results of surgery. The severity of current spine-related symptoms was a stronger correlate of physical functional status at the time of follow-up than age or nonspinal comorbid conditions.Conclusions: Seven to 10 years after decompressive surgery for spinal stenosis, 23% of patients had undergone reoperation and 33% of respondents had severe back pain. Despite a high prevalence of nonspinal problems in this elderly cohort, spinal symptoms were the most important correlate of reduced functional status.

'''Weinstein JN. Tosteson TD. Lurie JD. Tosteson AN. Blood E. Hanscom B. Herkowitz H. Cammisa F. Albert T. Boden SD. Hilibrand A. Goldberg H. Berven S. An H. SPORT Investigators. Surgical versus nonsurgical therapy for lumbar spinal stenosis.[see comment]. [Comparative Study. Journal Article. Multicenter Study. Randomized Controlled Trial. Research Support, N.I.H., Extramural] New England Journal of Medicine. 358(8):794-810, 2008 Feb 21.'''

Books

Canale & Beaty: Campbell's Operative Orthopaedics, 11th ed.

Copyright © 2007 Mosby, An Imprint of Elsevier —Preceding unsigned comment added by DrSculerati (talk • contribs) 14:24, 17 May 2008 (UTC)

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