Skip to main content

Operative Therapieverfahren bei der lumbalen Spinalkanalstenose

Vorläufige Ergebnisse einer randomisierten prospektiven klinischen Studie

  • Chapter
Der enge Spinalkanal
  • 52 Accesses

Zusammenfassung

Die chirurgische Therapie der degenerativen lumbalen Spinalkanalstenose erfolgt traditionell mit einer ausgedehnten Laminektomie [1, 3, 8, 10, 25]. Entsprechend einer Metaanalyse von Turner et al. [26] liegt die Erfolgsrate der Laminektomie bei 64%. Die relativ hohe Rate an nicht erfolgreichen Operationen wurde einerseits auf die Entwicklung einer postoperativen Instabilität und andererseits auf das ausgedehnte Gewebetrauma infolge der Knochenresektion und der Schädigung der paraspinalen Muskulatur zurückgeführt.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 59.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 79.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Literatur

  1. Airaksinen O, Herno A, Turunen V, Saari T, Suomlainen O (1997) Surgical outcome of 438 patients treated surgically for lumbar spinal stenosis. Spine 22:2278–2282

    Article  PubMed  CAS  Google Scholar 

  2. Aryanpur J, Ducker T (1990) Multilevel lumbar laminotomies: an alternative to laminectomy in the treatment of lumbar stenosis. Neurosurgery 26:429–432

    Article  PubMed  CAS  Google Scholar 

  3. Atlas SJ, Deyo RA, Keller RB, Chapin AM, Patrick DL, Long JM, Singer DE (1996) The Maine Lumbar Spine Study, Part III. l-year outcomes of surgical and nonsurgical management of lumbar spinal stenosis. Spine 21:1787–1794

    Article  PubMed  CAS  Google Scholar 

  4. Caspar W, Papavero L, Sayler MK, Harkey HL (1994) Precise and limited decompression for lumbar spinal stenosis. Acta Neurochir (Wien) 131:130–136

    Article  CAS  Google Scholar 

  5. Cornefjord M, Byrod G, Brisby H, Rydevik B (2000) A long-term (4-to 12-year) follow-up study of surgical treatment of lumbar spinal stenosis. Eur Spine J 9:563–570

    Article  PubMed  CAS  Google Scholar 

  6. Delank KS, Eysel P, Zollner J, Drees P, Nafe B, Rompe JD (2002) Undercutting decompression versus laminectomy. Clinical and radiological results of a prospective controlled trial. Orthopade 31:1048–1056

    Article  PubMed  CAS  Google Scholar 

  7. Eule JM, Breeze R, Kindt GW (1999) Bilateral partial laminectomy: a treatment for lumbar spinal stenosis and midline disc herniation. Surg Neurol 52:329–337

    Article  PubMed  CAS  Google Scholar 

  8. Iguchi T, Kurihara A, Nakayama J, Sato K, Kurosaka M, Yamasaki K (2000) Minimum 10-year outcome of decompressive laminectomy for degenerative lumbar spinal stenosis. Spine 25:1754–1759

    Article  PubMed  CAS  Google Scholar 

  9. Kalbarczyk A, Lukes A, Seiler RW (1998) Surgical treatment of lumbar spinal stenosis in the elderly. Acta Neurochir (Wien) 140:637–641

    Article  CAS  Google Scholar 

  10. Katz JN, Lipson SJ, Larson MG, McInnes JM, Fossel AH, Liang MH (1991) The outcome of decompressive laminectomy for degenerative lumbar stenosis. J Bone Joint Surg Am 73:809–816

    PubMed  CAS  Google Scholar 

  11. Katz JN, Lipson SJ, Chang LC, Levine SA, Fossel AH, Liang MH (1996) Seven-to 10-year outcome of decompressive surgery for degenerative lumbar spinal stenosis. Spine 21:92–98

    Article  PubMed  CAS  Google Scholar 

  12. Khoo LT, Fessler RG (2002) Microendoscopic decompressive laminotomy for the treatment of lumbar stenosis. Neurosurgery 51:146–154

    Google Scholar 

  13. Kleeman TJ, Hiscoe AC, Berg EE (2000) Patient outcomes after minimally destabilizing lumbar stenosis decompression: the “Port-Hole” technique. Spine 25:865–870

    Article  PubMed  CAS  Google Scholar 

  14. Lemaire JJ, Sautreaux JL, Chabannes J, Irthum B, Chazal J, Reynoso O, Thierry A (1995) Lumbar canal stenosis. Retrospective study of 158 operated cases. Neurochirurgie 41:89–97

    PubMed  CAS  Google Scholar 

  15. Mackay DC, Wheelwright EF (1998) Unilateral fenestration in the treatment of lumbar spinal stenosis. Br J Neurosurg 12:556–558

    Article  PubMed  CAS  Google Scholar 

  16. Mariconda M, Fava R, Gatto A, Longo C, Milano C (2002) Unilateral laminectomy for bilateral decompression of lumbar spinal stenosis: a prospective comparative study with conservatively treated patients. J Spinal Disord Tech 15:39–46

    Article  PubMed  Google Scholar 

  17. Nakai O, Ookawa A, Yamaura I (1991) Long-term roentgenographic and functional changes in patients who were treated with wide fenestration for central lumbar stenosis. J Bone Joint Surg Am 73:1184–1191

    PubMed  CAS  Google Scholar 

  18. Postacchini F, Cinotti G, Perugia D, Gumina S (1993) The surgical treatment of central lumbar stenosis. Multiple laminotomy compared with total laminectomy. J Bone Joint Surg Br 75:386–392

    PubMed  CAS  Google Scholar 

  19. Roland M, Morris R (1983) A study of the natural history of low-back pain. Part II: development of guidelines for trials of treatment in primary care. Spine 8:145–150

    Article  PubMed  CAS  Google Scholar 

  20. Rompe JD, Eysel P, Zollner J, Nafe B, Heine J (1999) Degenerative lumbar spinal stenosis. Long-term results after undercutting decompression compared with decompressive laminectomy alone or with instrumented fusion. Neurosurg Rev 22:102–106

    Article  PubMed  CAS  Google Scholar 

  21. Scott J, Huskisson EC (1976) Graphic representation of pain. Pain 2:175–184

    Article  PubMed  CAS  Google Scholar 

  22. Spetzger U, Bertalanffy H, Reinges MH, Gilsbach JM (1997) Unilateral laminotomy for bilateral decompression of lumbar spinal stenosis. Part II: Clinical experiences. Acta Neurochir (Wien) 139:397–403

    Article  CAS  Google Scholar 

  23. Thomas NW, Rea GL, Pikul BK, Mervis LJ, Irsik R, McGregor JM (1997) Quantitative outcome and radiographic comparisons between laminectomy and laminotomy in the treatment of acquired lumbar stenosis. Neurosurgery 41:567–574; discussion 574–565

    PubMed  CAS  Google Scholar 

  24. Tsai RY, Yang RS, Bray RS, Jr (1998) Microscopic laminotomies for degenerative lumbar spinal stenosis. J Spinal Disord 11:389–394

    Article  PubMed  CAS  Google Scholar 

  25. Tuite GF, Doran SE, Stern JD, McGillicuddy JE, Papadopoulos SM, Lundquist CA, Oyedijo DI, Grube SV, Gilmer HS, Schork MA et al (1994) Outcome after laminectomy for lumbar spinal stenosis. Part II: Radiographic changes and clinical correlations. J Neurosurg 81:707–715

    Article  PubMed  CAS  Google Scholar 

  26. Turner JA, Ersek M, Herron L, Deyo R (1992) Surgery for lumbar spinal stenosis. Attempted meta-analysis of the literature. Spine 17:1–8

    Article  PubMed  CAS  Google Scholar 

  27. Wang JC, Bohlman HH, Riew KD (1998) Dural tears secondary to operations on the lumbar spine. Management and results after a two-year-minimum follow-up of eighty-eight patients. J Bone Joint Surg Am 80:1728–1732

    Article  PubMed  CAS  Google Scholar 

  28. Weiner BK, Walker M, Brower RS, McCulloch JA (1999) Microdecompression for lumbar spinal canal stenos is. Spine 24:2268–2272

    Article  PubMed  CAS  Google Scholar 

  29. Wiesinger GF, Nuhr M, Quittan M, Ebenbichler G, Wolfl G, Fialka-Moser V (1999) Cross-cultural adaptation of the Roland-Morris questionnaire for German-speaking patients with low back pain. Spine 24:1099–1103

    Article  PubMed  CAS  Google Scholar 

  30. Young S, Veerapen R, O’Laoire SA (1988) Relief of lumbar canal stenosis using multilevel subarticular fenestrations as an alternative to wide laminectomy: preliminary report. Neurosurgery 23:628–633

    Article  PubMed  CAS  Google Scholar 

Download references

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2004 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Thomé, C., Leheta, O., Zevgaridis, D., Schmiedek, P. (2004). Operative Therapieverfahren bei der lumbalen Spinalkanalstenose. In: Pfeil, J., Rompe, JD. (eds) Der enge Spinalkanal. Steinkopff, Heidelberg. https://doi.org/10.1007/978-3-7985-1937-4_11

Download citation

  • DOI: https://doi.org/10.1007/978-3-7985-1937-4_11

  • Publisher Name: Steinkopff, Heidelberg

  • Print ISBN: 978-3-7985-1464-5

  • Online ISBN: 978-3-7985-1937-4

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics