[Lumbar spinal stenosis].
Lumbale Spinalkanalstenose.
Clinical symptoms
Degenerative spondylolisthesis
Implants
Microsurgical decompression
Spinal fusion
Journal
Orthopadie (Heidelberg, Germany)
ISSN: 2731-7153
Titre abrégé: Orthopadie (Heidelb)
Pays: Germany
ID NLM: 9918384887206676
Informations de publication
Date de publication:
Nov 2022
Nov 2022
Historique:
accepted:
02
08
2022
pubmed:
10
9
2022
medline:
18
11
2022
entrez:
9
9
2022
Statut:
ppublish
Résumé
Lumbar spinal stenosis (LSS) represents a frequent degenerative condition, however, striking a clear correlation between typical symptoms and imaging features remains a challenge. Reasons are a high prevalence of radiological LSS in the older population, a considerable percentage of asymptomatic LSS and the existence of differential diagnoses with similar symptomatology. This discrepancy also affects the outcomes - especially of surgically treated patients with LSS. When considering surgical decompression of LSS, the decision with regards to additive instrumentation and/or fusion remains a controversial point of discussion, in particular at the presence of degenerative spondylolisthesis. Recent, well-designed studies, however, clearly point towards a non-inferiority of decompression alone as opposed to the more invasive strategies. Die lumbale Spinalkanalstenose (LSS) stellt eine der häufigsten Behandlungsdiagnosen unter den degenerativen Wirbelsäulenerkrankungen dar, jedoch ist die Zuordnung entsprechender Beschwerden zu den typischen Bildbefunden einer LSS oft nicht klar. Die hohe Prävalenz von radiologischen Diagnosen einer LSS, ein hoher Prozentsatz an asymptomatischen/oligosymptomatischen LSS sowie die Existenz von Differenzialdiagnosen mit ähnlicher Symptomatik erschweren eine präzise Diagnose. Diese Situation hat Auswirkungen auf die Erfolgschancen insbesondere der operativen Therapien. Bei der operativen Dekompression wiederum existieren Fragen hinsichtlich der Verwendung von Implantaten/Fusionstechniken im Gegensatz zur alleinigen Dekompression und dies insbesondere in Fällen mit degenerativer Spondylolisthesis. Hier deuten neuere und qualitativ hochwertige Studien jedoch darauf hin, dass die alleinige Dekompression der umfangreicheren Versorgung durch Dekompression + Fusion nicht unterlegen ist.
Autres résumés
Type: Publisher
(ger)
Die lumbale Spinalkanalstenose (LSS) stellt eine der häufigsten Behandlungsdiagnosen unter den degenerativen Wirbelsäulenerkrankungen dar, jedoch ist die Zuordnung entsprechender Beschwerden zu den typischen Bildbefunden einer LSS oft nicht klar. Die hohe Prävalenz von radiologischen Diagnosen einer LSS, ein hoher Prozentsatz an asymptomatischen/oligosymptomatischen LSS sowie die Existenz von Differenzialdiagnosen mit ähnlicher Symptomatik erschweren eine präzise Diagnose. Diese Situation hat Auswirkungen auf die Erfolgschancen insbesondere der operativen Therapien. Bei der operativen Dekompression wiederum existieren Fragen hinsichtlich der Verwendung von Implantaten/Fusionstechniken im Gegensatz zur alleinigen Dekompression und dies insbesondere in Fällen mit degenerativer Spondylolisthesis. Hier deuten neuere und qualitativ hochwertige Studien jedoch darauf hin, dass die alleinige Dekompression der umfangreicheren Versorgung durch Dekompression + Fusion nicht unterlegen ist.
Identifiants
pubmed: 36083346
doi: 10.1007/s00132-022-04297-8
pii: 10.1007/s00132-022-04297-8
doi:
Types de publication
English Abstract
Journal Article
Langues
ger
Sous-ensembles de citation
IM
Pagination
943-952Commentaires et corrections
Type : ErratumIn
Informations de copyright
© 2022. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.
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