Lumbar Spinous Process-Splitting Technique for Ligamentum Flavum Cyst Removal.


Journal

Journal of neurological surgery. Part A, Central European neurosurgery
ISSN: 2193-6323
Titre abrégé: J Neurol Surg A Cent Eur Neurosurg
Pays: Germany
ID NLM: 101580767

Informations de publication

Date de publication:
07 Jun 2023
Historique:
pubmed: 8 12 2021
medline: 8 12 2021
entrez: 7 12 2021
Statut: aheadofprint

Résumé

 Laminotomy for lumbar stenosis is a well-defined procedure and represents a routine in every neurosurgical department. It is a common experience that the uni- or bilateral paraspinal muscle detachment, together with injury of the supra- and interspinous ligaments, can lead to postoperative pain. In the literature, the application of a minimally invasive technique, the lumbar spinous process-splitting (LSPS) technique, has been reported.  In this study, we present a case series of 12 patients who underwent LSPS from September 2019 to April 2020. Two patients had a cyst of the ligamentum flavum, eight a single-level lumbar canal stenosis (LCS), and two a two-level LCS. Moreover, we propose a novel morphological classification of postoperative muscle atrophy and present volumetric analysis of the decompression achieved.  There were no complications related to this technique. In all patients, the vertebral canal area was more than doubled by the procedure. The muscle sparing showed grade A, according to our classification.  To our knowledge, this is the first description of this surgical technique and the first LSPSL case series in Europe. Furthermore, cases of ligamentum flavum cyst removal using this safe and effective technique have not yet been reported.

Sections du résumé

BACKGROUND BACKGROUND
 Laminotomy for lumbar stenosis is a well-defined procedure and represents a routine in every neurosurgical department. It is a common experience that the uni- or bilateral paraspinal muscle detachment, together with injury of the supra- and interspinous ligaments, can lead to postoperative pain. In the literature, the application of a minimally invasive technique, the lumbar spinous process-splitting (LSPS) technique, has been reported.
METHODS METHODS
 In this study, we present a case series of 12 patients who underwent LSPS from September 2019 to April 2020. Two patients had a cyst of the ligamentum flavum, eight a single-level lumbar canal stenosis (LCS), and two a two-level LCS. Moreover, we propose a novel morphological classification of postoperative muscle atrophy and present volumetric analysis of the decompression achieved.
RESULTS RESULTS
 There were no complications related to this technique. In all patients, the vertebral canal area was more than doubled by the procedure. The muscle sparing showed grade A, according to our classification.
CONCLUSION CONCLUSIONS
 To our knowledge, this is the first description of this surgical technique and the first LSPSL case series in Europe. Furthermore, cases of ligamentum flavum cyst removal using this safe and effective technique have not yet been reported.

Identifiants

pubmed: 34875711
doi: 10.1055/a-1715-3958
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Thieme. All rights reserved.

Déclaration de conflit d'intérêts

None declared.

Auteurs

Santino Ottavio Tomasi (SO)

Department of Neurosurgery, Paracelsus Medical Private University, Salzburg, Austria.

Giuseppe Emmanuele Umana (GE)

Department of Neurosurgery, Cannizzaro Hospital, Catania, Italy.

Gianluca Scalia (G)

Department of Neurosurgery, National Specialist Hospital Garibaldi, Catania, Italy.

Giuseppe Raudino (G)

Department of Neurosurgery, Humanitas Centre of Oncology of Catania, Catania, Sicilia, Italy.

Vlado Stevanovic (V)

Department of Neuroradiology, Paracelsus Medical Private University, Salzburg, Austria.

Herbert Krainz (H)

Department of Neurosurgery, Paracelsus Medical Private University, Salzburg, Austria.

Michael Kral (M)

Department of Neurosurgery, Paracelsus Medical Private University, Salzburg, Austria.

Giovanni Federico Nicoletti (GF)

Department of Neurosurgery, National Specialist Hospital Garibaldi, Catania, Italy.

Peter A Winkler (PA)

Department of Neurosurgery, Paracelsus Medical University Salzburg, Salzburg, Salzburg, Austria.

Classifications MeSH