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Dickson, D. R., T. Boddice, and A. M. Collier. "A comparison of the functional difficulties in staged and simultaneous open carpal tunnel decompression." Journal of Hand Surgery (European Volume) 39, no. 6 (2013): 627–31. http://dx.doi.org/10.1177/1753193413509938.
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There is no agreement about whether patients with bilateral carpal tunnel syndrome should undergo staged or simultaneous open decompression. The purpose of this study was to quantify and compare the functional difficulties during the recovery from surgery for patients undergoing staged or simultaneous decompressions. Sixty-three patients had surgery; 33 had staged decompression (Group 1) and 30 simultaneous decompressions (Group 2). Functional difficulties were recorded using the Levine and Quick-DASH scores along with a visual analogue score for pain. There were no complications in either group. There was no significant difference in terms of pain or satisfaction. Functional difficulties were greater in the simultaneous group; however, there was no difference in completing simple tasks. Patients reported high satisfaction with either management approach. However, significantly fewer would consider undergoing simultaneous decompression again.
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BANDE, S., L. DE SMET, and G. FABRY. "The Results of Carpal Tunnel Release: Open Versus Endoscopic Technique." Journal of Hand Surgery 19, no. 1 (1994): 14–17. http://dx.doi.org/10.1016/0266-7681(94)90039-6.
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We retrospectively compared two similar groups of patients who underwent either endoscopic decompression of the carpal tunnel (single portal technique, 44 patients) or open decompression (58 patients) during 1 year in our department. To find out whether there was any subjective difference between the results of the two techniques, we sent each patient a questionnaire and received a 95% response. No major complications occurred. Three endoscopic decompressions had to be abandoned, and open release was performed. We could not demonstrate any significant difference in relief of symptoms and return to work between the two groups. Patient satisfaction at 6 to 18 months follow-up was high with both techniques.
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Huang, Jason H., and Eric L. Zager. "Mini-Open Carpal Tunnel Decompression." Neurosurgery 54, no. 2 (2004): 397–400. http://dx.doi.org/10.1227/01.neu.0000103669.45726.51.
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Abstract CARPAL TUNNEL SYNDROME is the most common entrapment neuropathy, and it is caused by compression of the median nerve at the wrist. The authors describe the mini-open carpal tunnel technique for surgical release of the transverse carpal ligament. The success of the procedure depends on meticulous technique with attention to certain important anatomic details and careful avoidance of injury to the palmar cutaneous nerve and the recurrent motor branch.
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Tessitore, Enrico, Claudio Schonauer, and Aldo Moraci. "Mini-open Carpal Tunnel Decompression." Neurosurgery 55, no. 4 (2004): 1010. http://dx.doi.org/10.1227/01.neu.0000139577.13399.d9.
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Huang, Jason H., and Eric L. Zager. "Mini-open Carpal Tunnel Decompression." Neurosurgery 55, no. 4 (2004): 1010. http://dx.doi.org/10.1093/neurosurgery/55.4.1010.
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Dangelmajer, Sean, Patricia L. Zadnik, Samuel T. Rodriguez, Ziya L. Gokaslan, and Daniel M. Sciubba. "Minimally invasive spine surgery for adult degenerative lumbar scoliosis." Neurosurgical Focus 36, no. 5 (2014): E7. http://dx.doi.org/10.3171/2014.3.focus144.
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Object Historically, adult degenerative lumbar scoliosis (DLS) has been treated with multilevel decompression and instrumented fusion to reduce neural compression and stabilize the spinal column. However, due to the profound morbidity associated with complex multilevel surgery, particularly in elderly patients and those with multiple medical comorbidities, minimally invasive surgical approaches have been proposed. The goal of this meta-analysis was to review the differences in patient selection for minimally invasive surgical versus open surgical procedures for adult DLS, and to compare the postoperative outcomes following minimally invasive surgery (MIS) and open surgery. Methods In this meta-analysis the authors analyzed the complication rates and the clinical outcomes for patients with adult DLS undergoing complex decompressive procedures with fusion versus minimally invasive surgical approaches. Minimally invasive surgical approaches included decompressive laminectomy, microscopic decompression, lateral and extreme lateral interbody fusion (XLIF), and percutaneous pedicle screw placement for fusion. Mean patient age, complication rates, reoperation rates, Cobb angle, and measures of sagittal balance were investigated and compared between groups. Results Twelve studies were identified for comparison in the MIS group, with 8 studies describing the lateral interbody fusion or XLIF and 4 studies describing decompression without fusion. In the decompression MIS group, the mean preoperative Cobb angle was 16.7° and mean postoperative Cobb angle was 18°. In the XLIF group, mean pre- and postoperative Cobb angles were 22.3° and 9.2°, respectively. The difference in postoperative Cobb angle was statistically significant between groups on 1-way ANOVA (p = 0.014). Mean preoperative Cobb angle, mean patient age, and complication rate did not differ between the XLIF and decompression groups. Thirty-five studies were identified for inclusion in the open surgery group, with 18 studies describing patients with open fusion without osteotomy and 17 papers detailing outcomes after open fusion with osteotomy. Mean preoperative curve in the open fusion without osteotomy and with osteotomy groups was 41.3° and 32°, respectively. Mean reoperation rate was significantly higher in the osteotomy group (p = 0.008). On 1-way ANOVA comparing all groups, there was a statistically significant difference in mean age (p = 0.004) and mean preoperative curve (p = 0.002). There was no statistically significant difference in complication rates between groups (p = 0.28). Conclusions The results of this study suggest that surgeons are offering patients open surgery or MIS depending on their age and the severity of their deformity. Greater sagittal and coronal correction was noted in the XLIF versus decompression only MIS groups. Larger Cobb angles, greater sagittal imbalance, and higher reoperation rates were found in studies reporting the use of open fusion with osteotomy. Although complication rates did not significantly differ between groups, these data are difficult to interpret given the heterogeneity in reporting complications between studies.
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Heikenfeld, Roderich, and Georgios Godolias. "Ulnar Nerve Decompression in Cubital Tunnel Syndrome – Open In Situ Decompression Versus Endoscopic Decompression." Arthroscopy: The Journal of Arthroscopic & Related Surgery 29, no. 10 (2013): e98. http://dx.doi.org/10.1016/j.arthro.2013.07.110.
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BORISCH, N., and P. HAUSSMANN. "Neurophysiological Recovery After Open Carpal Tunnel Decompression: Comparison of Simple Decompression and Decompression with Epineurotomy." Journal of Hand Surgery 28, no. 5 (2003): 450–54. http://dx.doi.org/10.1016/s0266-7681(03)00152-9.
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Two hundred and seventy-three patients with carpal tunnel syndrome without advanced neurophysiological changes (distal motor latency below 11 ms) were randomized to treatment by open carpal tunnel release with, or without, epineurotomy. Patients were examined clinically and by nerve conduction studies preoperatively and at 3, 6 and 12 months postoperatively. We found no statistically significant difference between simple decompression and decompression combined with epineurotomy with regard to either the clinical or the neurophysiological outcome.
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ERDMANN, M. W. H. "Endoscopic Carpal Tunnel Decompression." Journal of Hand Surgery 19, no. 1 (1994): 5–13. http://dx.doi.org/10.1016/0266-7681(94)90038-8.
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A study of endoscopic carpal tunnel release was carried out in three parts, consisting of initial cadaveric dissections, a prospective pilot study of 20 patients and a prospective, randomized trial of 71 patients comparing endoscopic with open decompression. In the main trial, 25 patients with bilateral symptoms underwent simultaneous endoscopic and open release, with the remainder randomized to one or other technique. Both techniques effectively decompressed the median nerve. A significant improvement in grip and pinch strength over 3 months was achieved in those undergoing endoscopic surgery. Average return to work was 14 days in the endoscopic series and 39 days in the open series. A complication rate of 35% was achieved with the transbursal endoscopic technique, 3.7% with the extrabursal endoscopic technique and 13.5% in the open series.
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Gizatullin, Sh Kh, A. S. Kristosturov, D. V. Davydov, A. V. Stanishevsky, and A. A. Povetkin. "Comparison of endoscopic and open methods of surgical treatment for lumbosacral spinal canal stenosis: a systematic literature review." Hirurgiâ pozvonočnika (Spine Surgery) 19, no. 1 (2022): 46–55. http://dx.doi.org/10.14531/ss2022.1.46-55.
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Objective. To analyze clinical outcomes and complication rates of transforaminal and interlaminar endoscopic decompression and open microsurgical operations performed for lumbosacral spinal canal stenosis.Material and Methods. The data of 60 literature sources selected in accordance with the inclusion and exclusion criteria in the PubMed, Science Direct, Google Scholar and Cochrane Library databases were systematized by evaluating diagnostic methods, clinical pictures and surgical treatment of the lumbar spinal canal stenosis. Original studies, case series and reviews containing information on surgical methods for the treatment of spinal stenosis at the lumbar level were analyzed.Results. The complication rate after transforaminal endoscopic decompression (relapses, infectious complications, damage to the dural membrane and spinal roots) does not exceed 2.7 %, which is significantly lower than that in open microsurgical operation (4.8–8.8 %). Endoscopic decompression and reconstruction of the spinal canal demonstrate good clinical outcomes, lower number of bed-days, readmissions, and good economic benefits. When stenosis is combined with instability of the spinal motion segment, performing only a decompressive operation in any volume does not give a significant clinical result, and stabilization surgery is required.Conclusion. The introduction of endoscopic reconstructive surgery for spinal canal stenosis in the lumbosacral spine is associated not only with technical progress and improvement of endoscopic optics, but also with the search for the causes of unsatisfactory results of open operations. Endoscopic interventions showed good clinical outcomes and a decrease in the complication rate. However, the evidence base needs to be expanded due to the lack of randomized trials to compare open decompression and stabilization, and endoscopic reconstructive surgeries in patients with various manifestations of spinal stenosis.
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Khoo, Larry T., and Richard G. Fessler. "Microendoscopic Decompressive Laminotomy for the Treatment of Lumbar Stenosis." Neurosurgery 51, suppl_2 (2002): S2–146—S2–154. http://dx.doi.org/10.1097/00006123-200211002-00020.
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Abstract OBJECTIVE By modifying existing microendoscopic discectomy techniques, we previously developed a novel surgical treatment of lumbar stenosis and validated its ability to achieve a thorough decompression in a cadaveric study. We now describe our clinical experience with this new, minimally invasive microendoscopic decompressive laminotomy (MEDL) technique. METHODS A MEDL was performed in 25 patients with classic features of lumbar stenosis. By use of a fluoroscopically guided percutaneous technique, the working portal was docked on the lamina with minimal soft-tissue injury. With the angle of the endoscope combined with an oblique entry, a bilateral bony and ligamentous decompression was achieved under the midline, thereby preserving the supraspinous–interspinous ligaments and contralateral musculature. A second group of 25 patients treated with open decompression was used for comparison. RESULTS Effective circumferential decompression was achieved in the majority of patients. The results for the MEDL group were as follows: operative time, 109 minutes per single level; blood loss, 68 ml; and postoperative stay, 42 hours. The results for the open-surgery group were as follows: operative time, 88 minutes; blood loss, 193 ml; and postoperative stay, 94 hours. The MEDL group needed significantly less narcotic medication after surgery. Overall, 16% of the MEDL patients reported resolution of their back pain, 68% improved symptomatically, and 16% remained unchanged. The outcome of the open group was very similar. CONCLUSION Compared with an equivalent open technique, MEDL appears to offer a similar short-term clinical outcome with a significant reduction in operative blood loss, postoperative stay, and use of narcotics. This lower surgical stress, decreased tissue trauma, and quicker recovery are particularly important in this elderly population of patients.
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LINDH, MAGNUS, and ROLF NORLIN. "Arthroscopic Subacromial Decompression Versus Open Acromioplasty." Clinical Orthopaedics and Related Research &NA;, no. 290 (1993): 174???176. http://dx.doi.org/10.1097/00003086-199305000-00022.
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Norlin, Rolf. "Arthroscopic subacromial decompression versus open acromioplasty." Arthroscopy: The Journal of Arthroscopic & Related Surgery 5, no. 4 (1989): 321–23. http://dx.doi.org/10.1016/0749-8063(89)90149-7.
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Van Holsbeeck, E., J. DeRycke, G. Declercq, M. Martens, J. Verstreken, and G. Fabry. "Subacromial impingement: Open versus arthroscopic decompression." Arthroscopy: The Journal of Arthroscopic & Related Surgery 8, no. 2 (1992): 173–78. http://dx.doi.org/10.1016/0749-8063(92)90032-7.
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Mohtadi, Nicholas G. H. "Arthroscopic Subacromial Decompression Versus Open Acromioplasty." Clinical Journal of Sport Medicine 4, no. 1 (1994): 65. http://dx.doi.org/10.1097/00042752-199401000-00011.
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Bromley, Gary S. "Minimal-incision open carpal tunnel decompression." Journal of Hand Surgery 19, no. 1 (1994): 119–20. http://dx.doi.org/10.1016/0363-5023(94)90234-8.
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Xu, Liu-yang, Kang-ming Chen, Jian-ping Peng, Jun-feng Zhu, Chao Shen, and Xiao-dong Chen. "Outcomes After Management of Subspine and Femoroacetabular Impingement Using a Direct Anterior Mini-Open Approach." Orthopaedic Journal of Sports Medicine 9, no. 12 (2021): 232596712110557. http://dx.doi.org/10.1177/23259671211055723.
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Background: Subspine impingement (SSI) has been commonly managed with arthroscopic decompression. However, arthroscopic decompression is a demanding technique, as under- or over-resection of the anterior inferior iliac spine (AIIS) could lead to inferior outcomes. An anterior mini-open approach has also been used in the management of femoroacetabular impingement (FAI), and it could provide adequate visualization of the anterior hip joint without a long learning curve. Purpose/Hypothesis: The objective of the current study was to compare the outcomes of SSI patients with FAI who underwent arthroscopic subspine decompression and osteoplasty with a group undergoing subspine decompression and osteoplasty using a modified direct anterior mini-open approach. It was hypothesized that there would be no significant difference in outcomes between the groups. Study Design: Cohort study; Level of evidence, 3. Methods: We reviewed the records of SSI patients who underwent decompression surgery (arthroscopic or mini-open) at our institution from June 1, 2015 to December 31, 2016. Both groups underwent the same postoperative rehabilitation protocol. Preoperative and 2-year postoperative patient-reported outcomes were compared using the modified Harris Hip Score (mHHS), International Hip Outcome Tool–33 (iHOT–33), and Hip Outcome Score—Activities of Daily Living (HOS–ADL). Major and minor complications as well as reoperation rates were recorded. Results: Included were 47 patients (49 hips) who underwent subspine decompression using an anterior mini-open approach and 35 patients (35 hips) who underwent arthroscopic subspine decompression. There were no differences in demographic and radiological parameters between the groups, and patients in both groups showed significant improvement in all outcome scores at follow-up. The pre- to postoperative improvement in outcome scores was also similar between groups (mini-open vs arthroscopy: mHHS, 26.30 vs 27.04 [ P = .783]; iHOT–33, 35.76 vs 31.77 [ P = .064]; HOS–ADL, 26.09 vs 22.77 [ P = .146]). In the mini-open group, 10 of the 47 patients had temporary meralgia paresthetica, and fat liquefaction was found in 1 female patient. There were no reoperations in the mini-open group. Conclusion: Subspine decompression using the anterior mini-open approach had similar outcomes to arthroscopic decompression in the management of SSI. The lateral femoral cutaneous nerve should be protected carefully during use of the anterior mini-open approach.
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Chauhan, Daksh, Yohannes Ghenbot, Hasan Shahzad Ahmad, et al. "1220 Shorter Hospitalization Observed Following Endoscopic Single-Level Lumbar Decompression Compared to Open Surgery: A Retrospective Analysis Of 2,527 Patients." Neurosurgery 71, Supplement_1 (2025): 193–94. https://doi.org/10.1227/neu.0000000000003360_1220.
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INTRODUCTION: Endoscopic lumbar decompression is a common surgical intervention for radiculopathy, offering potential benefits over open decompression, such as shorter operative times and faster postoperative recovery. Both endoscopic and open approaches improve patient quality of life, but further studies are needed to fully understand the advantages of the increasingly used endoscopic method. METHODS: Patients at an academic medical center who underwent single-level lumbar nerve root decompression from 2019-2023 via the endoscopic approach were compared to those who underwent open decompression during the same period. Data extracted from electronic health records included demographics, Charlson comorbidity index (CCI), operative time, LOS, and patient-reported outcome measures (PROMs). Student’s t-tests were used to compare differences based on surgical technique. RESULTS: 2527 patients (mean age 60.4 ± 14.8y) underwent lumbar nerve root decompression with either endoscopic (n=112) or open (n=2415) approaches. Endoscopic cases had a significantly lower LOS (0.67 days, IQR: 0 to 1 day) than open cases (1.63 days, IQR: 0 to 2 days), with no significant differences in gender, race, BMI, age, and CCI (p=5.10*10^-8). Patients who underwent endoscopic decompression (-1.55, IQR: -5 to 0) experienced a similar postoperative decrease in pain on the VAS scale as those who had open surgeries (-2.11, IQR: -5 to 0), indicating non-superiority of open approaches compared to fully endoscopic approaches (p=0.083). CONCLUSIONS: Endoscopic lumbar decompression resulted in shorter hospital stays compared to open techniques, while showing non-inferior improvement in pain scores. The shorter LOS is likely due to reduced tissue trauma from smaller incisions and minimal muscle manipulation. Although pain scores were similar between both methods, the reduced LOS with endoscopic techniques may decrease immediate postoperative healthcare utilization.
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Park, Cheol Woong, and Borriwat Santipas. "Unilateral Biportal Endoscopic Decompression for Thoracic Spinal Stenosis Secondary to Ossification of the Ligamentum Flavum." Journal of Minimally Invasive Spine Surgery and Technique 9, no. 2 (2024): 186–89. http://dx.doi.org/10.21182/jmisst.2024.01326.
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Ossification of the ligamentum flavum (OLF) in the thoracic spine is a cause of thoracic myelopathy that is more commonly found in East Asian populations (Koreans, Japanese, Chinese) than in others. Early diagnosis and sufficient surgical decompression can improve the functional prognosis for thoracic OLF. Surgical decompression is necessary and should be done as soon as the symptoms develop. There is a wide range of possible treatments, from standard open laminectomy to endoscopic decompression surgery. This video demonstrates the least invasive technique of decompressive laminectomy with bilateral decompression and removal of thoracic OLF through unilateral biportal endoscopic spinal surgery. The authors present the case of an 81-year-old male patient who presented with bilateral lower extremity weakness, numbness, pain, and ataxia. Magnetic resonance imaging and computed tomography scans of the whole spine showed the presence of OLF with severe spinal canal stenosis and a cord signal change at the T9–10 level. He underwent biportal endoscopic decompression and removal of thoracic OLF at T9–10. On the discharge day (postoperative day 7), motor power and pain had significantly improved. He could stand and independently ambulate with a walker.
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Heikenfeld, Roderich, Rico Listringhaus, and Georgios Godolias. "Ulnar Nerve Decompression in Cubital Tunnel Syndrome – Open in Situ Decompression Versus Endoscopic Decompression (SS-41)." Arthroscopy: The Journal of Arthroscopic & Related Surgery 29, no. 6 (2013): e20. http://dx.doi.org/10.1016/j.arthro.2013.03.048.
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Bisson, Erica F., Praveen V. Mummaneni, Michael S. Virk, et al. "Open versus minimally invasive decompression for low-grade spondylolisthesis: analysis from the Quality Outcomes Database." Journal of Neurosurgery: Spine 33, no. 3 (2020): 349–59. http://dx.doi.org/10.3171/2020.3.spine191239.
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OBJECTIVELumbar decompression without arthrodesis remains a potential treatment option for cases of low-grade spondylolisthesis (i.e., Meyerding grade I). Minimally invasive surgery (MIS) techniques have recently been increasingly used because of their touted benefits including lower operating time, blood loss, and length of stay. Herein, the authors analyzed patients enrolled in a national surgical registry and compared the baseline characteristics and postoperative clinical and patient-reported outcomes (PROs) between patients undergoing open versus MIS lumbar decompression.METHODSThe authors queried the Quality Outcomes Database for patients with grade I lumbar degenerative spondylolisthesis undergoing a surgical intervention between July 2014 and June 2016. Among more than 200 participating sites, the 12 with the highest enrollment of patients into the lumbar spine module came together to initiate a focused project to assess the impact of fusion on PROs in patients undergoing surgery for grade I lumbar spondylolisthesis. For the current study, only patients in this cohort from the 12 highest-enrolling sites who underwent a decompression alone were evaluated and classified as open or MIS (tubular decompression). Outcomes of interest included PROs at 2 years; perioperative outcomes such as blood loss and complications; and postoperative outcomes such as length of stay, discharge disposition, and reoperations.RESULTSA total of 140 patients undergoing decompression were selected, of whom 71 (50.7%) underwent MIS and 69 (49.3%) underwent an open decompression. On univariate analysis, the authors observed no significant differences between the 2 groups in terms of PROs at 2-year follow-up, including back pain, leg pain, Oswestry Disability Index score, EQ-5D score, and patient satisfaction. On multivariable analysis, compared to MIS, open decompression was associated with higher satisfaction (OR 7.5, 95% CI 2.41–23.2, p = 0.0005). Patients undergoing MIS decompression had a significantly shorter length of stay compared to the open group (0.68 days [SD 1.18] vs 1.83 days [SD 1.618], p < 0.001).CONCLUSIONSIn this multiinstitutional prospective study, the authors found comparable PROs as well as clinical outcomes at 2 years between groups of patients undergoing open or MIS decompression for low-grade spondylolisthesis.
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Paulin, Ethan, Evan C. Bowen, Shireen Dogar, John M. Sullivan, and Marc E. Walker. "Novel Technique for Single-Site, Ultrasound-Guided Release of the Cubital Tunnel." Annals of Plastic Surgery 94, no. 6S (2025): S564—S567. https://doi.org/10.1097/sap.0000000000004387.
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Introduction Current management via open dissection for cubital tunnel syndrome is efficacious; however, it can lead to lengthy recovery. Sonography can be utilized in open dissections for cubital tunnel syndrome to minimize incision lengths, but it has garnered interest in cadaveric studies for achieving entirely minimally invasive decompressions. Objective This study aimed to examine the feasibility of sonography in diagnosing cubital tunnel syndrome and propose a minimally invasive approach to decompression using a commercially available ultrasound-guided device, leveraging its success in carpal tunnel syndrome management. Methods Dissections were performed on three cadaveric arms. Presurgical mapping of the ulnar nerve was performed via ultrasonography, identifying the ulnar nerve traversing muscular and bony landmarks through the elbow. Operating bidirectionally via a single site at the level of the cubital tunnel, the carpal tunnel release system was utilized under ultrasound guidance, rigidly simulating surgical operation regarding time, technique, and care of dissection. Postoperative confirmation of decompression was achieved via open dissection. Results In all three specimens, successful fascial release was confirmed. There was no injury to the ulnar nerve itself or any motor branches, and there was no identifiable subluxation of the nerve with complete ranging of the elbow. Conclusions This study demonstrates the feasibility of in-office cubital tunnel decompression, addressing the growing demand for minimally invasive interventions. By adapting techniques from carpal tunnel syndrome management, this approach offers an alternative to traditional open surgery, particularly relevant amid limitations on operating theater access. Such innovative strategies hold promise for expanding surgical options and meeting the evolving needs of patients, emphasizing the importance of adapting established techniques to address emerging challenges in patient care.
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Basnet, Aashish, Maya Bhattachan, Sumit Joshi, et al. "Carpel ligament release for carpel tunnel syndrome (CTS) under local anesthesia: our experience with 277 cases." Nepal Journal of Neuroscience 16, no. 2 (2019): 3–7. http://dx.doi.org/10.3126/njn.v16i2.25938.
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Carpel tunnel syndrome (CTS) is one of the common neurological condition where median nerve is compressed by transverse carpel ligament at wrist. About 5% of general population suffer from this problem and most commonly occurred in young and middle-aged women. 30% of patients suffering from CTS can be managed by medications and physiotherapy and 70% may require surgical decompression at some stage. Surgical treatment is to decompress median nerve by releasing transverse carpel ligament either by open or endoscopic procedure. Both procedures have shown similar results. This is a retrospective study of 277 patients who underwent 349 decompressive surgical procedures under local anesthesia for CTS between May 2007 and April 2017 in our institute. Diagnosis was made from clinical signs and symptoms and confirmed by either NCV or EMG. All patients were operated in day care basis. Data were retrieved from OPD and OT records. Followed up duration ranged from 6 months to 10 years. There were 257 female and 20 male. 74% had unilateral and 26% had bilateral CTS. 93% CTS were idiopathic. 10% suffered postoperative complications.26% achieved immediate pain relief after decompression, 73% after three weeks and 98.5% after three months. Open decompression of CTS is a quick and simple OPD based surgical procedure.
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KLUGE, W., R. G. SIMPSON, and A. C. NICOL. "Late Complications after Open Carpal Tunnel Decompression." Journal of Hand Surgery 21, no. 2 (1996): 205–7. http://dx.doi.org/10.1016/s0266-7681(96)80098-2.
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66 patients (89 hands) were assessed at least 10 months after open carpal tunnel decompression. Tender scars were found in 19% of the hands and 4% were affected by pillar pain. Grip strength was reduced in more than half of the operated hands. Hypo- and anaesthesia in the scar area were affecting 7% but were not considered disabling. In 18% of the cases there was incomplete relief of primary symptoms.
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Lazarus, Mark D., Howard A. Chansky, Sanjay Misra, Gerald R. Williams, and Joseph P. Iannotti. "Comparison of open and arthroscopic subacromial decompression." Journal of Shoulder and Elbow Surgery 3, no. 1 (1994): 1–11. http://dx.doi.org/10.1016/s1058-2746(09)80001-3.
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Yousef, Justin, Patrick Chan, and Richard Rahdon. "Chronic Synovitis after Open Carpal Tunnel Decompression." Journal of Hand Surgery (Asian-Pacific Volume) 21, no. 02 (2016): 266–68. http://dx.doi.org/10.1142/s2424835516720115.
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Open carpal tunnel decompression is a common procedure with potential long-term complications such as scar tenderness, pillar pain and neuroma. We present the case of a 65 year-old male with chronic lipomatous hypertrophy of the wrist and chronic flexor tenosynovitis after open carpal tunnel release for its rarity and severity of symptoms that required further surgery.
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Mueller, Kyle, David Zhao, Osiris Johnson, Faheem A. Sandhu, and Jean-Marc Voyadzis. "The Difference in Surgical Site Infection Rates Between Open and Minimally Invasive Spine Surgery for Degenerative Lumbar Pathology: A Retrospective Single Center Experience of 1442 Cases." Operative Neurosurgery 16, no. 6 (2018): 750–55. http://dx.doi.org/10.1093/ons/opy221.
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Abstract BACKGROUND Surgical site infection (SSI) in spinal surgery contributes to significant morbidity and healthcare resource utilization. Few studies have directly compared the rate of minimally invasive surgery (MIS) SSI with open surgery. OBJECTIVE To investigate whether MIS techniques had a lower SSI rate in degenerative lumbar procedures as compared with traditional open techniques. METHODS A single-center, retrospective review of a prospectively collected database was queried from January 2013 to 2016 for adult patients who underwent lumbar decompression and/or instrumented fusion for which the surgical indication involved degenerative disease. The SSI rate was determined for all procedures as well as in the open and minimally invasive groups. Risk factors associated with SSI were also reviewed for each patient. RESULTS A total of 1442 lumbar spinal procedures were performed during this time period. Of these, there were 961 MIS and 481 open (67% vs 33%, respectively). The overall SSI rate was 1.5% (21/1442). The surgical site infection rate for MIS was less than open techniques (0.5% vs 3.3%; P = .0003). For decompression only, the infection rate for MIS and open was 0.4% vs 3.9% (P = .04), and for decompression with fusion it was 0.7% vs 2.6%, respectively (P = .68). CONCLUSION Our study demonstrates a significant 7-fold reduction in SSIs when comparing MIS with open surgery. This significance was also demonstrated with a 10-fold reduction for procedures involving decompression alone. Procedures that require fusion as well as decompression showed a trend towards a decreased infection rate that did not reach clinical significance.
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Braly, Brett A., David Lunardini, Chris Cornett, and William F. Donaldson. "Operative Treatment of Cervical Myelopathy: Cervical Laminoplasty." Advances in Orthopedics 2012 (2012): 1–5. http://dx.doi.org/10.1155/2012/508534.
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Cervical spondylotic myelopathy (CSM) is a degenerative process which may result in clinical signs and symptoms which require surgical intervention. Many treatment options have been proposed with various degrees of technical difficulty and technique sensitive benefits. We review laminoplasty as a motion-sparing posterior decompressive method. Current literature supports the use of laminoplasty for indicated decompression. We also decribe our surgical technique for an open-door, or “hinged”, laminoplasty.
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Schmidt, Sarah, Waltraud Kleist Welch-Guerra, Marc Matthes, Jörg Baldauf, Ulf Schminke, and Henry W. S. Schroeder. "Endoscopic vs Open Decompression of the Ulnar Nerve in Cubital Tunnel Syndrome." Neurosurgery 77, no. 6 (2015): 960–71. http://dx.doi.org/10.1227/neu.0000000000000981.
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Abstract BACKGROUND: Prospective randomized data for comparison of endoscopic and open decompression methods are lacking. OBJECTIVE: To compare the long- and short-term results of endoscopic and open decompression in cubital tunnel syndrome. METHODS: In a prospective randomized double-blind study, 54 patients underwent ulnar nerve decompression for 56 cubital tunnel syndromes from October 2008 to April 2011. All patients presented with typical clinical and neurophysiological findings and underwent preoperative nerve ultrasonography. They were randomized for either endoscopic (n = 29) or open (n = 27) surgery. Both patients and the physician performing the follow-up examinations were blinded. The follow-up took place 3, 6, 12, and 24 months postoperatively. The severity of symptoms was measured by McGowan and Dellon Score, and the clinical outcome by modified Bishop Score. Additionally, the neurophysiological data were evaluated. RESULTS: No differences were found regarding clinical or neurophysiological outcome in both early and late follow-up between both groups. Hematomas were more frequent after endoscopic decompression (P = .05). The most frequent constrictions were found at the flexor carpi ulnaris (FCU) arch and the retrocondylar retinaculum. We found no compressing structures more than 4 cm distal from the sulcus in the endoscopic group. The outcome was classified as “good” or “excellent” in 46 out of 56 patients (82.1%). Eight patients did not improve sufficiently or had a relapse and underwent a second surgery. CONCLUSION: The endoscopic technique showed no additional benefits to open surgery. We could not detect relevant compressions distal to the FCU arch. Therefore, an extensive far distal endoscopic decompression is not routinely required. The open decompression remains the procedure of choice at our institution.
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Pakzaban, Peyman. "Technique for Mini-open Decompression of Chiari Type I Malformation in Adults." Operative Neurosurgery 13, no. 4 (2017): 465–70. http://dx.doi.org/10.1093/ons/opx027.
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Abstract BACKGROUND: The technique for decompression of Chiari type I malformation relies on open exposure of craniocervical junction for suboccipital craniectomy and upper cervical laminectomy with or without duraplasty. There is no detailed technical report of a minimally invasive approach for Chiari decompression in adults. OBJECTIVE: To describe a mini-open technique for decompression of Chiari type I malformation (including duraplasty) in adults. METHODS: Six consecutive adult patients with symptomatic Chiari type I malformation underwent decompression through a 3 to 4 cm midline incision via a speculum retractor. All patients underwent a limited suboccipital craniectomy and C1 laminectomy with an ultrasonic bone scalpel. All patients underwent duraplasty with a synthetic dural substitute. In the 2 patients with syringomyelia, the arachnoid was opened and intradural dissection was carried out. In the remaining 4 patients, the arachnoid was left intact. RESULTS: All operations were completed successfully through the mini-open exposure. Mean surgery time, blood loss, and length of stay were 114 min, 55 mL, and 1.3 days, respectively. Mean follow-up was 13.2 months (range 9-18). All patients had excellent clinical outcomes as defined by scores of 15 (3 patients) or 16 (3 patients) on Chicago Chiari Outcome Scale. There were no neurological complications or cerebrospinal fluid leaks. Postop computed tomography revealed good boney decompression. In the 2 patients with syringomyelia, MRI at 6 months revealed resolution of the syrinx. CONCLUSION: Decompression of Chiari type I malformation in adults can be performed safely and effectively through the mini-open exposure described in this report.
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LUZ, LUCAS XAVIER DA, MARCELO SIMONI SIMÕES, BRUNO DE AZEVEDO OLIVEIRA, GUILHERME JOSÉ MIOTTO, and ERNANI VIANNA DE ABREU. "AGGRESSIVE VERTEBRAL HEMANGIOMAS – CASE SERIES AND LITERATURE REVIEW." Coluna/Columna 19, no. 4 (2020): 293–96. http://dx.doi.org/10.1590/s1808-185120201904223670.
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ABSTRACT Objectives To present a series of aggressive hemangiomas of the institution, with a review of the management options described in the literature. Methods This is a retrospective survey of aggressive vertebral hemangiomas treated by the service in the last 10 years, with histological confirmation of the diagnosis and a minimum follow-up of 1 year. The case analysis and literature review were conducted with emphasis on treatment options for these injuries. Results Seven cases were found, three with pain and four with severe neurological deficits. Two patients were treated with open decompression, one with open decompression and cementation, one with open decompression and arthrodesis, one with biopsy and cementation, one with percutaneous biopsy, and one with open biopsy followed by decompression surgery. All patients underwent radiotherapy. There was a significant regression of presentation deficits, but one patient developed an irreversible deficit during treatment. There were no recurrences or late complications in the follow-up period. Conclusions Surgical decompression in patients with significant neurological deficit is a point of consensus in the literature. Subtotal resection followed by radiation therapy was effective in treating deficits and controlling pathology. Cases manifesting pain only can be managed with minimally invasive techniques, whether or not they are followed by radiotherapy. Level of evidence IV; Therapeutic study of case series.
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Zygourakis, Corinna C., A. Karim Ahmed, Samuel Kalb, et al. "Technique: open lumbar decompression and fusion with the Excelsius GPS robot." Neurosurgical Focus 45, videosuppl1 (2018): V6. http://dx.doi.org/10.3171/2018.7.focusvid.18123.
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The Excelsius GPS (Globus Medical, Inc.) was approved by the FDA in 2017. This novel robot allows for real-time intraoperative imaging, registration, and direct screw insertion through a rigid external arm—without the need for interspinous clamps or K-wires. The authors present one of the first operative cases utilizing the Excelsius GPS robotic system in spinal surgery. A 75-year-old man presented with severe lower back pain and left leg radiculopathy. He had previously undergone 3 decompressive surgeries from L3 to L5, with evidence of instability and loss of sagittal balance. Robotic assistance was utilized to perform a revision decompression with instrumented fusion from L3 to S1. The usage of robotic assistance in spinal surgery may be an invaluable resource in minimally invasive cases, minimizing the need for fluoroscopy, or in those with abnormal anatomical landmarks.The video can be found here: https://youtu.be/yVI-sJWf9Iw.
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Grunert, Peter, Phillip M. Reyes, Anna G. U. S. Newcomb, et al. "Biomechanical Evaluation of Lumbar Decompression Adjacent to Instrumented Segments." Neurosurgery 79, no. 6 (2016): 895–904. http://dx.doi.org/10.1227/neu.0000000000001419.
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Abstract BACKGROUND: Multilevel lumbar stenosis, in which 1 level requires stabilization due to spondylolisthesis, is routinely treated with multilevel open laminectomy and fusion. We hypothesized that a minimally invasive (MI) decompression is biomechanically superior to open laminectomy and may allow decompression of the level adjacent the spondylolisthesis without additional fusion. OBJECTIVE: To study the mechanical effect of various decompression procedures adjacent to instrumented segments in cadaver lumbar spines. METHODS: Conditions tested were (1) L4-L5 instrumentation, (2) L3-L4 MI decompression, (3) addition of partial facetectomy at L3-L4, and (4) addition of laminectomy at L3-L4. Flexibility tests were performed for range of motion (ROM) analysis by applying nonconstraining, pure moment loading during flexion-extension, lateral bending, and axial rotation. Compression flexion tests were performed for motion distribution analysis. RESULTS: After instrumentation, MI decompression increased flexion-extension ROM at L3-L4 by 13% (P = .03) and axial rotation by 23% (P = .003). Partial facetectomy further increased axial rotation by 15% (P = .03). After laminectomy, flexion-extension ROM further increased by 12% (P = .05), a 38% increase from baseline, and axial rotation by 17% (P = .02), a 58% increase from baseline. MI decompression yielded no significant increase in segmental contribution of motion at L3-L4, in contrast to partial facetectomy and laminectomy (&lt;.05). CONCLUSION: MI tubular decompression is biomechanically superior to open laminectomy adjacent to instrumented segments. These results lend support to the concept that in patients in whom a multilevel MI decompression is performed, the fusion might be limited to the segments with actual instability.
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Parrish, Frank A., and Richard L. Pyle. "Field Comparison of Open-Circuit Scuba to Closed-Circuit Rebreathers for Deep Mixed-Gas Diving Operations." Marine Technology Society Journal 36, no. 2 (2002): 13–22. http://dx.doi.org/10.4031/002533202787914052.
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A comparison of open-circuit scuba diving to closed-circuit (“rebreather”) diving was conducted while collecting fishery data on black coral beds in Hawaii. Both methodologies used mixed gas from the same ship-based support system. The comparison was based on a series of eight dives, four open-circuit and four closed-circuit. These were used to make a direct-comparison of the gear in a square dive profile, a multilevel profile and two dives of varying profiles. Four general criteria were considered: time requirements for topside equipment preparation and maintenance, consumption of expendables, decompression efficiency, and potential dive durations and bailout capabilities for each of the two technologies. The open-circuit divers required 4 times as much topside equipment preparation as the rebreather divers, consumed 17 times as much gas, and cost 7 times more in expendables. The open-circuit divers incurred 42% more decompression time for the square profile dives and 70% more decompression time for the multilevel profile dives than the closed-circuit dive team. Most of the decompression advantage for the closed-circuit team is from the benefit of real-time decompression calculations, but some benefit comes from the breathing gas optimization inherent to rebreathers. For a given mass of equipment, the rebreathers allow for as much as 7.7 times more bottom time, or emergency bailout capability (depending on the chosen depth of the dive), compared with the open-circuit system.
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Pillai, Anand, Vivek Eranki, Joby Malal, and Gavin Nimon. "Outcomes of Open Subacromial Decompression after Failed Arthroscopic Acromioplasty." ISRN Surgery 2012 (May 9, 2012): 1–5. http://dx.doi.org/10.5402/2012/806843.
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Aim. To prospectively assess the effectiveness of revision with open subacromial decompression in patients who had a previous unsatisfactory outcome with the arthroscopic procedure. Methods. 11 patients were identified for the study, who did not demonstrate expected improvement in symptoms after arthroscopic acromioplasty. All patients underwent structured rehabilitation. Functional evaluation was conducted using the Hospital for Special Surgery, New York, shoulder rating questionnaire. Results. M : F was 7 : 4. The mean age was 57 years. The average shoulder score improved from 49.6 preoperatively to 56 postoperatively at an average followup of 16 months. Two patients showed deterioration in their shoulder scores after revision while the rest showed only marginal improvement. All except one patient stated that they would opt for surgery again if given a second chance. Conclusion. In the group of patients that fail to benefit from the arthroscopic decompression, only a marginal improvement was noted after revision with open decompression.
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Chou, Dean, and Daniel C. Lu. "Mini-open transpedicular corpectomies with expandable cage reconstruction." Journal of Neurosurgery: Spine 14, no. 1 (2011): 71–77. http://dx.doi.org/10.3171/2010.10.spine091009.
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Transpedicular corpectomies are frequently used to perform anterior surgery from a posterior approach. Minimally invasive thoracolumbar corpectomies have been previously described, but these are performed through a unilateral approach. Bilateral access must be obtained for a circumferential decompression when using such techniques. The authors describe a technique that allows for a mini-open transpedicular corpectomy, 360° decompression, and expandable cage reconstruction through a single posterior approach. This is performed using percutaneous pedicle screws, the trap-door rib-head osteotomy, and a single midline fascial exposure. The authors describe this technique with intraoperative photos and a video demonstrating the technique.
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Ju, Chang-Il, Pius Kim, and Jong Hun Seo. "Full-Endoscopic J-Shaped Transforaminal L5 Nerve Decompression in Bertolotti Syndrome." Neurospine 21, no. 4 (2024): 1131–36. https://doi.org/10.14245/ns.2449112.556.
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This case report and video demonstrate the technique of full-endoscopic J-shaped transforaminal L5 exiting nerve decompression in Bertolotti syndrome. Bertolotti syndrome, characterized by a congenital lumbosacral transitional vertebra, often results in mechanical lower back pain and nerve root compression. A 69-year-old male presented with progressive radiating pain in the right leg and tingling in the L5 dermatome. Lumbar spine MRI revealed a right foraminal disc herniation at the L5–S1 level, with calcification and foraminal stenosis. The patient was also diagnosed with Castellvi type I Bertolotti syndrome, featuring a large L5 transverse process and a high iliac crest. These anatomical variations complicated the transforaminal approach, creating a narrow safety zone for conventional methods. The approach began with docking on the L5 transverse process. Endoscopic drilling was performed in a J-shaped configuration to partially resect the transverse process and alar wing, facilitating endoscope insertion into Kambin’s triangle. Foraminal decompression was achieved by removing the tip of the superior articular process (SAP), thereby decompressing the L5 exiting nerve root. Full-endoscopic spine surgery offers a safe and effective alternative to traditional open techniques for L5 nerve decompression in Bertolotti syndrome. This video presentation illustrates the intraoperative endoscopic approach, detailing the decompression techniques and highlighting the minimally invasive advantages of this method.
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Isakov, I. D., A. J. Sanginov, Sh A. Akhmetyanov, E. A. Mushkachev, A. N. Sorokin, and A. V. Peleganchuk. "Direct lateral interbody fusion with indirect decompression of the spinal roots in patients with degenerative lumbar spinal stenosis." Genij Ortopedii 30, no. 6 (2024): 897–905. https://doi.org/10.18019/1028-4427-2024-30-6-897-905.
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Introduction Degenerative spine conditions involve the gradual loss of normal structure of the spine among the population and remain a common form of work-limiting health condition in 80 % of the population. The demand for surgical interventions will remain high in an aging population to improve quality of life. Lumbar spinal decompression and stabilization are produced using ventral, posterior and lateral approaches. Lateral lumbar interbody fusion (LLIF) is used for treatment of degenerative lumbar stenosis having advantages over surgical interventions from other approaches.The objective was to determine the prospects of LLIF as an independent decompressive and stabilizing surgical intervention using literature data.Material and methods This article presents generalized information from Russian and foreign publications on LLIF with indirect decompression of the lumbar nerve roots. The original literature search was conducted on key resources including Scientific Electronic Library (www.elibrary.ru), the National Library of Medicine (www.pubmed.org) and Scopus using keywords: direct lateral interbody fusion, indirect decompression of the spinal nerve roots, predictors, lateral lumbar interbody fusion, direct lumbar interbody fusion, extreme lumbar interbody fusion, indirect decompression. The review included 60 articles published between 1998 and 2023 inclusive.Results and discussion After performing LLIF, some patients experience indirect decompression of the spinal nerve roots to prevent epidural fibrosis, injury to the dura mater and spinal nerve roots. Identifying a model of patients with degenerative spinal stenosis who can undergo LLIF as an independent decompressivestabilizing surgical intervention without additional instrumentation can improve the effectiveness of surgical treatment.Conclusion LLIF was shown to be an effective method for indirect decompression of spinal nerve roots at the intervertebral foramina. Indirect decompression of the spinal nerve roots in the spinal canal may fail and the choice of a LLIF candidate (a single surgical intervention) remains open.
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Mitrović, Mihajlo, and Dražen Jelača. "Mini-open carpal tunnel release technique." Halo 194 27, no. 2 (2021): 52–57. http://dx.doi.org/10.5937/halo27-31322.
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Introduction/Aim: Carpal tunnel syndrome (CST) is the most common cause of upper extremity compressive neuropathy. Until the introduction of endoscopy, the dominant surgical method was classic open surgery. The objective of the paper is to examine the efficacy, safety and economic value of the mini-open carpal tunnel release technique using a longitudinal 2 cm long incision in the carpal region. Methods: The diagnosis was made based on clinical examination, followed by an ENMG. The study includes only patients with idiopathic CTS, while those who have developed CTS as a result of secondary causes have been excluded from the study. All patients were operated on under local anaesthesia, WALANT, without the use of a tourniquet. A longitudinal incision 2 cm long is made in the line of the radial edge of the ring finger, 2-3 cm distal to the wrist flexion crease, immediately proximal of the Caplan cardinal line and ulnar to the thenar crease. Upon cutting through the skin and subcutaneous soft tissue, the superficial fascia is identified and then cut with the same scalpel in the same direction and the same length. The transversal ligament is then identified and carefully incised with a scalpel enough to allow further decompression with the use of scissors. Using standard surgical scissors for the hand, the ligament is cut proximally to the forearm fascia and then distally until a faint crackling sound is heard, which means that the ligament had been completely cut. This must be checked by inserting the Freer elevator proximally and distally to the edge of the ligament. Now it is possible to identify the nerve and accompanying hand flexor tendons. Sutures are placed only on the skin and a roll of gauze is fixed to the wound with an elastic bandage to provide compression. The first check-up is on the very next day and the patient is advised to start doing hand exercises. The sutures are removed 10-14 days after surgery. Results: From January 2018 to December 2019, 35 carpal tunnel decompressions were performed on 30 patients using the mini-open decompression technique and standard surgical scissors. The surgery was performed on 22 patients in the operating room and 8 patients in the infirmary. There were no intraoperative complications. All patients reported no night pain from the very first day after surgery. Pillar pain, incision pain and hand weakness were progressively becoming less pronounced during the next 12 weeks. At the final check-up, only one patient still had pronounced symptoms that required a reintervention. The rest of the patients had completely recovered. Even though the endoscopic procedure for carpal tunnel decompression is constantly evolving, the classic open method and newly developed mini-open carpal tunnel release technique remain the treatments of choice. Conclusion: Our research shows that the mini-open carpal tunnel release technique is a quick, efficient, safe and cheap surgical technique for treating carpal tunnel compressive neuropathy.
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POVLSEN, B., I. TEGNELL, M. REVELL, and L. ADOLFSSON. "Touch Allodynia Following Endoscopic (Single Portal) or Open Decompression for Carpal Tunnel Syndrome." Journal of Hand Surgery 22, no. 3 (1997): 325–27. http://dx.doi.org/10.1016/s0266-7681(97)80395-6.
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We investigated if single-portal endoscopic carpal tunnel decompression equipment (Agee®, 3M, USA) would cause increased carpal tunnel pressure during the release and if endoscopic release would reduce postoperative touch allodynia. Measurements on cadavers of the pressure produced during endoscopic release showed similar pressures to those produced during maximal range of motion. One hundred patients underwent either open or endoscopic decompressions. Twenty normal individuals served as controls. At 1 month after surgery both groups had significant allodynia compared with the controls, but at 3 months the endoscopic group had returned to normal though the open group was still significantly abnormal. The reported endoscopic release may therefore be of particular advantage to patients who would seriously be disadvantaged if postoperative touch allodynia should develop. The Agee® endoscope is unlikely to cause disturbance of the nerve function due to increased carpal pressure during the release.
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Yadav, Divya, Nikita Sonawane, and Santosh Ramesh. "Decompression retinopathy following self sealing open globe injury." Indian Journal of Ophthalmology - Case Reports 2, no. 2 (2022): 575. http://dx.doi.org/10.4103/ijo.ijo_2267_21.
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Friedman, Robert L., and David S. Morrison. "Recurrent acromial bone spur after open subacromial decompression." Journal of Shoulder and Elbow Surgery 4, no. 6 (1995): 468–71. http://dx.doi.org/10.1016/s1058-2746(05)80040-0.
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Schnake, Klaus John. "Open bilateral interlaminar decompression in lumbar spinal stenosis." European Spine Journal 25, S2 (2016): 278–79. http://dx.doi.org/10.1007/s00586-016-4611-4.
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Yahya, Ayesha, Andrew R. Malarkey, Ryan L. Eschbaugh, and H. Brent Bamberger. "Trends in the Surgical Treatment for Cubital Tunnel Syndrome: A Survey of Members of the American Society for Surgery of the Hand." HAND 13, no. 5 (2017): 516–21. http://dx.doi.org/10.1177/1558944717725377.
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Background: Cubital tunnel syndrome is the second most common compression neuropathy affecting the upper extremity. The aim of this study was to determine the preferred surgical treatment for cubital tunnel syndrome by members of the American Society for Surgery of the Hand (ASSH). Methods: We invited members of the ASSH research mailing list to complete our online survey. They were presented with 6 hypothetical cases and asked to choose their preferred treatment from the following options: open in situ decompression, endoscopic decompression, submuscular transposition, subcutaneous transposition, medial epicondylectomy, and conservative management. This was assessed independently and anonymously through an online survey (SurveyMonkey). Results: 1069 responses were received. Seventy-three percent of the respondents preferred to continue conservative management when a patient presented with occasional paresthesias for greater than 6 months with a normal electromyogram (EMG) or nerve conduction velocity (NCV). Sixty-five percent picked open in situ decompression if paresthesias, weakness of intrinsics, and EMG/NCV reports of mild to moderate ulnar nerve entrapment was present. More than 50% of respondents picked open in situ decompression, as their preferred treatment when sensory loss of two-point discrimination of less than 5 or more than 10 was present in addition to the findings mentioned above. Seventy-nine percent of the respondents said their treatment algorithm would change if ulnar nerve subluxation was present. Conclusions: Our survey results indicate that open in situ decompression is the preferred operative procedure, if there is no ulnar nerve subluxation, among hand surgeons for cubital tunnel syndrome.
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Guha, Daipayan, Robert F. Heary, and Mohammed F. Shamji. "Iatrogenic spondylolisthesis following laminectomy for degenerative lumbar stenosis: systematic review and current concepts." Neurosurgical Focus 39, no. 4 (2015): E9. http://dx.doi.org/10.3171/2015.7.focus15259.
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OBJECT Decompression without fusion for degenerative lumbar stenosis is an effective treatment for both the pain and disability of neurogenic claudication. Iatrogenic instability following decompression may require further intervention to stabilize the spine. The authors review the incidence of postsurgical instability following lumbar decompression, and assess the impact of surgical technique as well as study design on the incidence of instability. METHODS A comprehensive literature search was performed to identify surgical cohorts of patients with degenerative lumbar stenosis, with and without preexisting spondylolisthesis, who were treated with laminectomy or minimally invasive decompression without fusion. Data on patient characteristics, surgical indications and techniques, clinical and radiographic outcomes, and reoperation rates were collected and analyzed. RESULTS A systematic review of 24 studies involving 2496 patients was performed, assessing both open laminectomy and minimally invasive bilateral canal enlargement. Postoperative pain and functional outcomes were similar across the various studies, and postoperative radiographie instability was seen in 5.5% of patients. Instability was seen more frequently in patients with preexisting spondylolisthesis (12.6%) and in those treated with open laminectomy (12%). Reoperation for instability was required in 1.8% of all patients, and was higher for patients with preoperative spondylolisthesis (9.3%) and for those treated with open laminectomy (4.1%). CONCLUSIONS Instability following lumbar decompression is a common occurrence. This is particularly true if decompression alone is selected as a surgical approach in patients with established spondylolisthesis. This complication may occur less commonly with the use of minimally invasive techniques; however, larger prospective cohort studies are necessary to more thoroughly explore these findings.
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Regev, Gilad J., Gil Leor, Ran Ankori, et al. "Long-Term Pain Characteristics and Management Following Minimally Invasive Spinal Decompression and Open Laminectomy and Fusion for Spinal Stenosis." Medicina 57, no. 10 (2021): 1125. http://dx.doi.org/10.3390/medicina57101125.
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Background and Objectives: To compare the long-term pain characteristics and its chronic management following minimally invasive spinal (MIS) decompression and open laminectomy with fusion for lumbar stenosis. Materials and Methods: The study cohort included patients with a minimum 5-year postoperative follow-up after undergoing either MIS decompression or laminectomy with fusion for spinal claudication. The primary outcome of interest was chronic back and leg pain intensity. Secondary outcome measures included pain frequency during the day, chronic use of non-opioid analgesics, narcotic medications, medical cannabinoids, and continuous interventional pain treatments. Results: A total of 95 patients with lumbar spinal stenosis underwent one- or two-level surgery for lumbar spinal stenosis between April 2009 and July 2013. Of these, 50 patients underwent MIS decompression and 45 patients underwent open laminectomy with instrumented fusion. In the fusion group, a higher percentage of patients experienced moderate-to-severe back pain with 48% compared to 21.8% of patients in the MIS decompression group (p < 0.01). In contrast, we found no significant difference in the reported leg pain in both groups. In the fusion group, 20% of the patients described their back and leg pain as persistent throughout the day compared to only 2.2% in the MIS decompression group (p < 0.05). A trend toward higher chronic dependence on analgesic medication and repetitive pain clinic treatments was found in the fusion group. Conclusions: MIS decompression for the treatment of degenerative spinal stenosis resulted in decreased long-term back pain and similar leg pain outcomes compared to open laminectomy and instrumented fusion surgery.
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Kim, Dae-Geun, Eugene J. Park, Woo-Kie Min, Sang-Bum Kim, Gaeun Lee, and Sung Choi. "Comparison of Hidden Blood Loss in Biportal Endoscopic Spine Surgery and Open Surgery in the Lumbar Spine: A Retrospective Multicenter Study." Journal of Clinical Medicine 14, no. 11 (2025): 3878. https://doi.org/10.3390/jcm14113878.
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Background/Objectives: Biportal endoscopic spine surgery (BESS) is one of the minimally invasive spine surgery techniques. BESS has several advantages, such as better visualization, less muscle injury, early rehabilitation, etc. Due to its clear visualization, delicate intraoperative hemostasis of the bleeding foci, including cancellous bone and small epidural vessels, can be achieved. Therefore, some authors have reported that BESS resulted in less intraoperative visible blood loss (VBL) compared to conventional open surgery. However, it is difficult to analyze the exact amount of intraoperative blood loss because of the continuous normal saline irrigation. In addition, hidden blood loss (HBL) tends to be overlooked, and the amount of HBL might be larger than expected. We aim to calculate the amount of HBL during BESS and to compare our findings with convention open surgery. Methods: We retrospectively obtained the clinical data of patients that underwent lumbar central decompression from July 2021 to June 2024. Patients were divided into two groups: the BESS group that underwent biportal endoscopic lumbar decompression, and the open surgery group that underwent open decompression. Both groups used unilateral laminotomy and bilateral decompression techniques. Total blood loss (TBL) using preoperative and postoperative change in hematocrit (Hct) was measured using Gross’s formula and the Nadler equation. Since TBL consists of VBL and HBL, HBL was calculated by subtracting the VBL measured intraoperatively from TBL. Results: A total of sixty-six patients in the BESS group and seventeen patients in the open surgery group were included in the study. The TBL was 247.16 ± 346.88 mL in the BESS group and 298.71 ± 256.65 mL in the open surgery group, without significant difference (p = 0.569). The calculated HBL values were 149.44 ± 344.08 mL in the BESS group and 171.42 ± 243.93 mL in the open surgery group. The HBL in the BESS group was lower than the HBL in the open surgery group, without significant difference (p = 0.764). Conclusions: The TBL and HBL during lumbar central decompression were smaller in patients who underwent BESS compared to those who underwent open surgery. While TBL was significantly lower in BESS, HBL did not show statistical significance between the two groups. HBL during BESS should not be neglected, and related hemodynamics should be considered postoperatively.
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Бывальцев, В. А., А. А. Калинин, В. В. Шепелев, et al. "Comparative analysis of the results of decompressive interventions in elderly patients with cauda equine syndrome caused by lumbar spinal stenosis." Успехи геронтологии, no. 4 (October 31, 2022): 529–37. http://dx.doi.org/10.34922/ae.2022.35.4.011.
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Цель исследования - оценка результатов хирургического лечения и эффективности клинического восстановления пациентов пожилого возраста с синдромом конского хвоста (СКХ), обусловленного дегенеративным стенозом позвоночного канала, после выполнения открытой и минимально-инвазивной декомпрессии. Проведен ретроспективный анализ послеоперационных исходов у 50 пациентов старше 60 лет, которым выполнены изолированные открытые ( n =21) и минимально-инвазивные ( n =29) декомпрессивные вмешательства по поводу СКХ, обусловленного стенозом позвоночного канала. Для сравнительной оценки использовали технические особенности вмешательства, специфичность послеоперационного ведения пациентов, клинические исходы и периоперационные осложнения. В результате установлены преимущества малотравматичной изолированной декомпрессии в сравнении с открытой по меньшему объему кровопотери и продолжительности госпитализации, низкой потребности пациентов в послеоперационном обезболивании, минимальному количеству периоперационных хирургических осложнений, динамике неврологической симптоматики, лучшему клиническому восстановлению функционального состояния по шкале ODI и качеству жизни по опроснику SF-36 в отдаленном послеоперационном периоде. The aim of the study was to evaluate the results of surgical treatment and the effectiveness of clinical recovery in elderly patients with cauda equina syndrome (CES) caused by degenerative spinal canal stenosis after isolated open and minimally invasive decompression. A retrospective analysis of the results of surgical treatment of 50 patients over 60 years of age who underwent isolated open (n=21) and minimally invasive (n=29) decompressive interventions for CES caused by lumbar spinal stenosis was performed. For comparative analysis, we used the technical features of the intervention, the specificity of postoperative management of patients, clinical parameters, and the number of perioperative complications. As a result, the advantages of minimally invasive isolated decompression compared to open decompression due to a smaller volume of blood loss and duration of hospitalization, low need for postoperative pain relief, a minimum number of perioperative surgical complications, as well as the dynamics of neurological symptoms, better efficiency of clinical recovery of functional state indicators according to ODI and quality life according to SF-36 in the late postoperative period.
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Wu, Pang Hung, Hyeun Sung Kim, and Il-Tae Jang. "How I do it? Uniportal full endoscopic contralateral approach for lumbar foraminal stenosis with double crush syndrome." Acta Neurochirurgica 162, no. 2 (2019): 305–10. http://dx.doi.org/10.1007/s00701-019-04157-z.
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Abstract Background Evolution of endoscopic surgery provides equivalent results to open surgery with advantages of minimal invasive surgery. The literature on technique Uniportal Full endoscopic contralateral approach is scarce. Methods The endoscopic contralateral approach technique applies for patients presenting with double crush syndrome with foraminal and extraforminal stenosis. The key steps focus on contralateral ventral overriding superior articular process decompression, foraminal and extraforaminal discectomy, and lateral vertebral syndesmophyte decompression leading to enlargement of the contralateral foramen and extraforamen size. Conclusion The Uniportal Full endoscopic contralateral approach is a good alternative to open surgery or minimally invasive microscopic surgery through direct endoscopic visualization of the entire route of exiting nerve with no neural retraction allowing both lateral recess and foraminal and extraforaminal decompression all in one approach.
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Schöller, Karsten, Marjan Alimi, Guang-Ting Cong, Paul Christos, and Roger Härtl. "Lumbar Spinal Stenosis Associated With Degenerative Lumbar Spondylolisthesis: A Systematic Review and Meta-analysis of Secondary Fusion Rates Following Open vs Minimally Invasive Decompression." Neurosurgery 80, no. 3 (2017): 355–67. http://dx.doi.org/10.1093/neuros/nyw091.
Full textAbstract:
Abstract BACKGROUND: Decompression without fusion is a treatment option in patients with lumbar spinal stenosis (LSS) associated with stable low-grade degenerative spondylolisthesis (DS). A minimally invasive unilateral laminotomy (MIL) for “over the top” decompression might be a less destabilizing alternative to traditional open laminectomy (OL). OBJECTIVE: To review secondary fusion rates after open vs minimally invasive decompression surgery. METHODS: We performed a literature search in Pubmed/MEDLINE using the keywords “lumbar spondylolisthesis” and “decompression surgery.” All studies that separately reported the outcome of patients with LSS+DS that were treated by OL or MIL (transmuscular or subperiosteal route) were included in our systematic review and meta-analysis. The primary end point was secondary fusion rate. Secondary end points were total reoperation rate, postoperative progression of listhetic slip, and patient satisfaction. RESULTS: We identified 37 studies (19 with OL, 18 with MIL), with a total of 1156 patients, that were published between 1983 and 2015. The studies’ evidence was mostly level 3 or 4. Secondary fusion rates were 12.8% after OL and 3.3% after MIL; the total reoperation rates were 16.3% after OL and 5.8% after MIL. In the OL cohort, 72% of the studies reported a slip progression compared to 0% in the MIL cohort, respectively. After OL, satisfactory outcome was 62.7% compared to 76% after MIL. CONCLUSION: In patients with LSS and DS, minimally invasive decompression is associated with lower reoperation and fusion rates, less slip progression, and greater patient satisfaction than open surgery.